Endocrine Abstracts

Secondary causes for Hypertension account for 5% of hypertension cases. Renal Artery Stenosis due to Fibromuscular Dysplasia is an uncommon cause of Secondary Hypertension. This is a case of a 35-year old lady who presented with headache and vomiting and was found to have malignant hypertension with resultant acute left caudate nucleus infarct in the brain. A mild hypokalaemia on admission prompted measurement of renin and aldosterone which were both elevated. She also had elevated plasma normetadrenaline. This prompted an Endocrinology referral. It was noted that she was on SSRI and this could account for the slightly elevated normetadrenaline. An Ultrasound scan of the kidneys was reviewed and there was 3 cm difference in the size of the kidneys with the left kidney being smaller. Magnetic Resonance – angiogram of renal arteries confirmed features in keeping with left renal artery stenosis secondary to Fibromuscular Dysplasia. The patient was successfully treated with renal artery angioplasty.