Positive captopril renal scintigraphy in a patient with extensive bilateral renal interlobar arterial disease.
The authors determined an unusual cause of renovascular hypertension in a 29-year-old man with the recent onset of hypertension and a history of intravenous substance abuse. Captopril renal scintigraphy (CRS) demonstrated bilateral renogram changes and a decrease in estimated global glomerular filtration rate. The abdominal aortogram failed to show renal artery or branch artery stenosis. Magnified selective views of the kidneys demonstrated extensive, bilateral, small vessel interlobar disease. Two major points are illustrated in this patient. First, in the presence of positive CRS results and a history of renovascular hypertension, bilateral, selective, magnified renal angiography should be performed in accordance with standard abdominal aortic views when large vessel disease is not detected. Second, although surgical intervention is not an option in such patients, finding the cause of hypertension is important for patient management.
Department of Radiology, University of Illinois at Chicago, College of Medicine.
D W
DW
Trepashko
D
D
Warner
J
J
Arruda
D G
DG
Pavel
D000328:Adult; D002216:Captopril; D005919:Glomerular Filtration Rate; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging* / Q000209:etiology; D007457:Iodine Radioisotopes; D007465:Iodohippuric Acid; D008297:Male; D011859:Radiography; D011866:Radioisotope Renography / Q000379:methods; D012077:Renal Artery / Q000000981:diagnostic imaging; D015819:Substance Abuse, Intravenous / Q000150:complications; D016284:Technetium Tc 99m Pentetate
D007457:Iodine Radioisotopes; D007465:Iodohippuric Acid; D002216:Captopril; D016284:Technetium Tc 99m Pentetate