A young man with a renal colic

. We report the case of a 35‐year‐old man with no cardiovascular morbidity, presenting with acute flank pain, microscopic haematuria and normal blood pressure. Initially diagnosed as a ureteral colic, the patient was recovered 6 weeks later with severe hypertensive crisis. Further investigations rev...

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Bibliographic Details
Published in:Journal of internal medicine 2003-12, Vol.254 (6), p.605-608
Main Authors: Barbey, F., Matthieu, C., Nseir, G., Burnier, M., Teta, D.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Colic - etiology
Diagnosis, Differential
fibromuscular dysplasia
Fibromuscular Dysplasia - complications
Fibromuscular Dysplasia - diagnosis
Flank Pain - etiology
Humans
hypertension
Infarction - complications
Kidney - blood supply
Kidney Diseases - etiology
Kidneys
Male
Medical sciences
Nephrology. Urinary tract diseases
renal infarction
Urinary Calculi - diagnosis
Urinary system involvement in other diseases. Miscellaneous
urolithiasis
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Summary:. We report the case of a 35‐year‐old man with no cardiovascular morbidity, presenting with acute flank pain, microscopic haematuria and normal blood pressure. Initially diagnosed as a ureteral colic, the patient was recovered 6 weeks later with severe hypertensive crisis. Further investigations revealed a massive renal infarction secondary to medial fibromuscular dysplasia (FMD). Several aspects of this presentation are intriguing. Renal infarcts are usually seen in older patients having cardiac problems and/or major atheromatous plaques. In addition, FMD is mainly observed in young females and rarely progresses to renal artery occlusion. Furthermore, in this case, FMD remained silent until the acute renal infarction occurred, despite a significant kidney size reduction at the time of diagnosis. Finally, the observation of a delayed hypertensive response to a major renovascular insult provides incentives to discuss possible pathophysiological mechanisms involved in renovascular hypertension.
ISSN:0954-6820
1365-2796
DOI:10.1111/j.1365-2796.2003.01214.x