title: [Mid-aortic syndrome: case studies from a paediatric nephrology department].
abstract: BACKGROUND
  Mid-aortic syndrome (MAS) describes a narrowing segment of the abdominal aorta and the branches arising from there. This narrowing frequently involves the renal arteries, with the only clinical sign being arterial hypertension.
  
  
  OBJECTIVE
  To review the cases of MAS diagnosed in the Paediatric Nephrology Department of the Vall D'Hebron Hospital (Barcelona).
  
  
  METHODS
  A retrospective study was conducted on 5 patients aged from 8 days to 12 years old. We analysed the onset, diagnostic examinations, treatment and outcome.
  
  
  RESULTS
  Hypertension was the common reason behind the study. In two of the five cases, it was associated with renal failure. The definitive diagnostic was made using angiography and angio-MR, observing, in all the cases, that the renal arteries were affected (in 3 cases unilateral). The treatment was by medication in 3 cases, 1 required surgery and 1 died at 7 months.
  
  
  CONCLUSIONS
  MAS, although uncommon, is a very important cause of AHT in infancy. Angiography is the only technique to diagnose it. It is important to rule out cerebral involvement, which could lead to a fatal outcome. Hypertension is very difficult to control through medication. Surgery is required only when the hypertension is not controllable through medication, when there is intermittent claudication, intestinal angina, and renal hypoperfusion. Ideally, it is better to opt for medication as treatment, as the narrowing is progressive up to the end of puberty, after which, the narrowing stabilises.
authors.affiliation: Servicio de Nefrología Infantil del Hospital Materno-Infantil Vall d'Hebron, Barcelona, España. sarachocron501@msn.com
authors.forename: S
authors.initials: S
authors.lastname: Chocrón de Benzaquen
authors.forename: M
authors.initials: M
authors.lastname: Muñoz López
authors.forename: A D
authors.initials: AD
authors.lastname: Madrid Aris
authors.forename: A
authors.initials: A
authors.lastname: Castellote Alonso
authors.forename: G
authors.initials: G
authors.lastname: Enriquez
authors.forename: J L
authors.initials: JL
authors.lastname: Nieto Rey
mesh_terms: D001012:Aorta, Abdominal; D001018:Aortic Diseases / Q000175:diagnosis / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D017809:Fatal Outcome; D005260:Female; D006748:Hospital Departments; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009398:Nephrology; D010372:Pediatrics; D012189:Retrospective Studies; D013577:Syndrome