[Primary antiphospholipid syndrome associated with malignant hypertension].
The antiphospholipid syndrome is defined by the presence of antiphospholipid antibodies and recurrent thrombosis, affecting the venous system more frequently than the arterial one. Renal involvement is only observed in approximately 20-25% of cases, main renal artery thrombosis has been exceptionally described. We report a 39-year-old woman with previous history of recurrent thrombosis diagnosed as primary antiphospholipid syndrome, who presented malignant hypertension in the context of a renal artery thrombosis. She had a high IgG anticardiolipin antibody titre and positive lupus anticoagulant. An isotopic renogram demonstrated asymmetrical activity (60% right vs 40% left kidney). Renal arteriography demonstrated preoclusive thrombosis in the left renal artery. Blood pressure was well controlled by the use of ACE-inhibitor and alpha blockers.
Ribera
L
L
Servicio de Nefrología, Corporació Sanitaria Parc Taulí, Institut Universitari Parc Taulí, Universitat Autónoma de Barcelona, Sabadell.
Vallvé
M
M
Almirall
J
J
D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D017153:Antibodies, Anticardiolipin / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000150:complications*; D019917:Blood Vessel Prosthesis Implantation; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006974:Hypertension, Malignant / Q000188:drug therapy / Q000209:etiology*; D006978:Hypertension, Renovascular / Q000188:drug therapy / Q000209:etiology*; D011859:Radiography; D012008:Recurrence; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery; D019851:Thrombophilia / Q000209:etiology; D013927:Thrombosis / Q000209:etiology* / Q000601:surgery; D020246:Venous Thrombosis / Q000150:complications
D000317:Adrenergic alpha-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D017153:Antibodies, Anticardiolipin; D003278:Contraceptives, Oral, Hormonal