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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although patients with systemic lupus erythematosus (SLE), especially those with antiphospholipid antibodies, have a high incidence of arterial and venous thrombotic manifestations, renal infarction has been rarely reported in these patients and is probably underestimated. A 9-year-old boy with renal infarction, diagnosed by computed tomography and scintigraphy, is described. Initially he complained of severe flank pain; he had no urinary abnormalities and his blood pressure was normal. No evidence of systemic disease was found. He responded well to antibiotic treatment without the need for immunosuppressive therapy. In subsequent years he presented a spectrum of clinical symptoms, including fever, malaise, arterial hypertension headache, and mononeuritis multiplex, accompanied by an increased erythrocyte sedimentation rate and transitory proteinuria. This suggested vasculitis involving peripheral vessels as well as the central nervous system. Treatment with oral prednisone and azathioprine led to remission. Four years after the renal infarction, the child presented with recurrence of systemic disease. The diagnosis of SLE was established, with positive antiphospholipid antibodies. The sudden appearance of severe unexplained flank pain should alert the clinician to a possible underlying renal vessel thrombosis. Renal venous thrombosis is probably much more common; however, renal arterial thrombosis and infarction in association with SLE with positive antiphospholipid antibodies should be added to the differential diagnosis.
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PMID:Renal infarction in a child with systemic lupus erythematosus. 1506 40

A gastrointestinal stromal tumor of the stomach mimicking an adrenal tumor in a 67-year-old woman is reported. The patient sought medical attention for left flank pain in December 2001. A spherical calcification was evident in the left hypochondrium in an abdominal radiography, and computed tomography revealed a mass 8 cm in diameter at the upper pole of the left kidney. She then was admitted to our hospital. Physical examination and laboratory screening showed hypertension, diabetes mellitus and slight hemoconcentration. Endocrine examination showed normal serum adrenal hormone concentrations. Magnetic resonance imaging again demonstrated the mass, which showed enhancement along its margins after intravenous contrast administration. With a preoperative diagnosis of adrenal tumor, we performed total resection. The pediculated tumor, arising from the stomach, showed c-kit immunohistochemical staining permitting a histopathological diagnosis of gastrointestinal stromal tumor.
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PMID:[Gastrointestinal stromal tumor of the stomach mimicking adrenal tumor: a case report]. 1568 56

Primary dissecting aneurysms of the renal artery are exceedingly rare. The triad of flank pain, hematuria, and hypertension of acute onset in the absence of urinary obstruction should suggest this rare condition. We report a case of spontaneous dissecting aneurysm of the renal artery treated using conservative medical treatment. The diagnosis, therapeutic management, and outcome are discussed.
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PMID:Spontaneous dissecting aneurysm of the renal artery: a case report. 1569 92

We report a rare case of asymptomatic adrenal medullary hyperplasia detected by chance with intraoperative hypertension during surgery for ipsilateral renal cell carcinoma. A 41-year-old male visited our hospital with a complaint of left flank pain. He had normal blood pressure and plasma catecholamine level was within normal limits. Ultrasonogram and CT scan revealed a left renal tumor but did not showed any abnormal masses in the left adrenal gland. The clinical diagnosis was renal cell carcinoma and we performed left total nephrectomy. In the process of operative manipulation, however, the blood pressure and pulse rate of this patient showed a marked increase. Pathological examination of the extirpated kidney revealed renalcell carcinoma, while the resected adrenal gland was diagnosed as adrenal medullary hyperplasia.
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PMID:Asymptomatic adrenal medullary hyperplasia detected with intraoperative hypertension: a case report. 1597 98

Renal artery aneurysm are uncommon. The true prevalence of renal aneurysms in the general population is unknown (less than 0.4%). Because of more widespread use of Angiography and CT as well as improved imaging techniques, they are diagnosed more frecuently. Fibromuscular dysplasia and arteriosclerotic occlusion of the renal artery are believed to be the most frecuent causes. In general, there are no pathognomonic signs and symptoms of renal aneurysm. Nonspecific complaints include flank pain, hematuria, hypertension and hypotension (suspect rupture of aneurysm). We report a case of a woman with a renal artery calcified aneurysm in a solitary kidney.
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PMID:[Renal artery calcified aneurysm in a female patient with solitary kidney, rare pathology]. 1605 Feb 2

Primary renal lymphoma (PRL) is a rare lymphoma which usually presents with hematuria, flank pain, abdominal mass, and weight loss. PRL is more diagnosed in adults than children. We describe an asymptomatic child who presented with hypertension and was subsequently diagnosed with primary renal lymphoma. This case represents an atypical presentation for PRL.
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PMID:Primary renal lymphoma presenting with hypertension. 1615 23

Inflammatory aneurysms represent only 3-10% of all aortoiliac aneurysms and tend to be more common in men. We report a case of a solitary inflammatory aneurysm of the right common iliac artery in a healthy young woman. The patient presented with persistent abdominal and right flank pain. She had no risk factors for vascular disease, except mild hypertension and a strong family history of aneurysm disease. Her work-up demonstrated a 3.0 cm right common iliac artery aneurysm with intramural thrombus, focal calcification, and perianeurysmal inflammation without evidence of systemic atherosclerosis. There was right hydroureteronephrosis secondary to ureteral compression by the inflammatory aneurysm. She underwent open right common iliac artery aneurysmorraphy with polytetrafluoroethylene interposition graft and concomitant ureterolysis without complication. She remains asymptomatic more than 1 year postoperatively with no evidence of additional aneurysm disease, resolution of her hydroureteronephrosis, and normal kidney function. We report a rare case of a solitary inflammatory aneurysm of the right common iliac artery in a healthy young woman, with a review of the current literature on inflammatory aneurysms.
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PMID:Solitary common iliac artery inflammatory aneurysm in a healthy woman: case report and review of the literature. 1618 40

Mesoaortic compression of left renal vein produces left renal vein hypertension resulting in left flank pain, hematuria and pelvic-ureteral varices. This is called the nutcracker syndrome. The nutcracker syndrome has been treated in various ways. We recently experienced two cases of patients with nutcracker syndrome. We treated the patients with transposition of their left renal vein.
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PMID:Transposition of the left renal vein in nutcracker syndrome. 1620 30

Polycystic kidney disease, an inherited systemic disorder, is characterized by the development of multiple cysts in the kidneys and other organs. Patients can present at any age, but more often come to clinical attention (unless there is a family history) after age 30. Patients who are diagnosed before age 30 have a worse renal survival. Although palpation of the abdomen occasionally provides a clue to the presence of polycystic kidney disease, radiographic procedures most often suggest the diagnosis. Mutations in the PKD1 or PKD2 genes give rise to cyst formation. Flank pain, hematuria, polyuria, nephrolithiasis, urinary tract infections, and hypertension may be part of the syndrome of polycystic kidney disease. It is the fourth most common cause of end-stage renal disease. Blood pressure treatment goals are less than 130/80 mm Hg. Treatment should include the use of angiotensin-converting enzyme inhibitors.
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PMID:Polycystic kidney disease. 1622 65

Compression of the left renal vein between the aorta and the superior mesenteric artery has been termed the nutcracker syndrome. Obstruction of left renal vein outflow results in venous hypertension with the formation of intra- and extrarenal collaterals and/or the development of gonadal vein reflux. To date, a variety of clinical symptoms due to mesoaortic compression of the left renal vein (nutcracker syndrome) have been described. It is not known what pathophysiological variables play a role in the different clinical manifestations of nutcracker syndrome. We report two patients representing the two different forms of the condition. In the first, hematuria and left flank pain resolved in a young man after successful renocaval reimplantation. In the second, symptoms of pelvic congestion due to pelvic varices improved in a middle-aged woman after successful embolization of the gonadal vein and pelvic collaterals. This report reviews the pathophysiology, presentation, diagnosis including radiographic findings, management options, as well as the current literature on nutcracker syndrome.
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PMID:Mesoaortic compression of the left renal vein (nutcracker syndrome): case reports and review of the literature. 1741 6


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