title: An exceptional case of renal artery restenosis in a patient with polycythaemia vera.
abstract: Polycythaemia vera represents a rare chronic myeloproliferative neoplasm characterized by an increased thrombotic risk. Previous case reports have documented a link between primary or secondary polycythemia and the presence of renal artery stenosis and renovascular hypertension. Herein, we report an exceptional case of renal artery restenosis leading to uncontrolled hypertension in a patient with PV and high haematocrit levels. A 52-year-old female patient with a history of polycythaemia vera under treatment with hydroxyurea and phlebotomy presented in our outpatient clinic with newly diagnosed hypertension caused by left renal artery stenosis. Six months after stenting, patient returned for a follow-up visit due to uncontrolled hypertension and high haematocrit levels. Total restenosis of the left renal artery was found. Patient received optical medical treatment and was prescribed to higher doses of hydroxyurea by her treating haematologist. Since then, blood pressure and Hct levels remain adequately controlled. As described by earlier case reports, renal artery stenosis, hypertension and polycythemia often coexist. However, renovascular hypertension may not only lead to secondary erythrocytosis but also be a thrombotic complication of primary erythrocytosis. Thus, patients with polycythaemia vera should be carefully evaluated and optimally managed when hypertension or impaired renal function coexist.
authors.affiliation: a3rd Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki bDepartment of Nephrology, General Hospital of Edessa, Edessa cHematology Department and Hematopoietic Cell Transplantation (HCT) Unit, G. Papanicolaou Hospital, Thessaloniki, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Gavriilaki
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Sampanis
authors.forename: Christos
authors.initials: C
authors.lastname: Kavlakoudis
authors.forename: George
authors.initials: G
authors.lastname: Papaioannou
authors.forename: Sotirios
authors.initials: S
authors.lastname: Vasileiou
mesh_terms: D000800:Angioplasty, Balloon; D000970:Antineoplastic Agents / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006400:Hematocrit; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D008875:Middle Aged; D018962:Phlebotomy; D011087:Polycythemia Vera / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D012078:Renal Artery Obstruction / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D015607:Stents
chemical_list: D000970:Antineoplastic Agents; D006918:Hydroxyurea