title: Misleading diagnosis of renal artery stenosis by magnetic resonance angiography in a patient with primary aldosteronism.
abstract: A 24-year-old woman presented with severe hypertension. A diagnostic evaluation for secondary hypertension was undertaken. A duplex ultrasonography followed by a magnetic angiography suspected fibromuscular dysplasia. Unexpectedly, a contrast-enhanced angiography performed for renal angioplasty showed normal renal arteries. Primary aldosteronism was then evoked on the basis of decreased plasma renin and increased plasma aldosterone and aldosterone/renin ratio. After a CT-scan disclosed a left adrenal tumour, the patient underwent a left laparoscopic adrenalectomy. Pathological findings confirmed a benign adrenocortical adenoma. Blood pressure and aldosterone levels were normalized after surgery. Thus, clinicians should be aware of false-positive results of magnetic resonance angiography that could hide other causes of secondary hypertension.
authors.affiliation: Services of Endocrinology, University Hospital of Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium. vanessa.ippersiel@uclouvain.be
authors.forename: V
authors.initials: V
authors.lastname: Ippersiel
authors.forename: A
authors.initials: A
authors.lastname: Rosière
authors.forename: L
authors.initials: L
authors.lastname: Michel
authors.forename: J
authors.initials: J
authors.lastname: Donckier
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006973:Hypertension / Q000209:etiology; D018810:Magnetic Resonance Angiography; D012077:Renal Artery / Q000000981:diagnostic imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D055815:Young Adult