SECONDARY ARTERIAL HYPERTENSION: A CASE REPORT OF FIBROMUSCULAR DYSPLASIA

Abstract

Fibromuscular dysplasia (FMD) is an idiopathic, non-inflammatory, non-atherosclerotic systemic disease characterized by stenosis, occlusion, aneurysm, dissection and tortuosity of arterial beds. Arterial hypertension (HTN) is the most common manifestation of FMD of renal arteries.
This article describes a clinical case suggestive of FMD as cause of secondary hypertension – a 47-year-old woman with long-term and difficult-to-control HTN, with multiple end-organ damage and history of acute kidney injury associated with the introduction of Valsartan; analytically, the patient had increased plasma aldosterone/renin ratio (32.5:1) and imagiologically reduction of the caliber of renal arteries and celiac trunk, ischemia of the left kidney and aneurysms of the pancreatic-duodenal, lumbar and cerebral arteries was observed.

The diagnosis of FMD is based on clinical evaluation and imaging tests (renal arteriography is the gold-standard, but non-invasive tests are considered reasonable alternatives). Treatment includes medical therapy, and revascularization (angioplasty or surgery) may be considered if the benefits outweigh the risks of the procedure.