10 March 2019
: Case report
Congenital Renal Arteriovenous Malformation: A Rare but Treatable Cause of Hypertension
Challenging differential diagnosis, Rare disease
Nicholas Isom1BE*, Reza Masoomi2ABCE, Adam Alli3BD, Kamal Gupta2ABCDEDOI: 10.12659/AJCR.912727
Am J Case Rep 2019; 20:314-317
Abstract
BACKGROUND: Congenital renal vascular anomalies have been classified into 3 categories: cirsoid, angiomatous, and aneurysmal. These classifications are based on the size, location, and number of vessels involved. Aneurysmal malformations, such as the one reported here, have a single (and dilated) feeding and draining vessel. The prevalence of renal AVMs is estimated at less than 0.04%, making them rare causes of secondary hypertension.
CASE REPORT: A 29-year-old white woman was seen in the hypertension clinic as a referral from high-risk obstetric clinic for management of hypertension (HTN). A secondary hypertension workup with Doppler waveforms of the renal arteries revealed prominent diastolic flow in the left compared to the right. For confirmation, an MRA was done, which showed a large left renal upper-pole arteriovenous malformation (AVM) with associated vascular shunting and early opacification of the left renal vein. This congenital AVM was identified as the cause of her hypertension. Angiography and coil embolization were performed. The patient’s BP normalized within a few days and she was taken off her antihypertensive medications.
CONCLUSIONS: This case illustrates that a careful review of duplex waveforms beyond just peak velocity and ratios is important to identify uncommon pathologies. This is important, as renal AVMs respond well to embolization, with resolution of hypertension in 59% of patients treated.
Keywords: Arteriovenous Malformations, Catheterization, Peripheral, Hypertension, Renovascular, Renal Artery, Renal Veins
In Press
27 Jan 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.938548
26 Jan 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.938169
26 Jan 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.939026
26 Jan 2023 : Case report
Am J Case Rep In Press; DOI: 10.12659/AJCR.938982
Most Viewed Current Articles
13 Jul 2022 : Case report
DOI :10.12659/AJCR.936441
Am J Case Rep 2022; 23:e936441
06 Dec 2021 : Case report
DOI :10.12659/AJCR.934406
Am J Case Rep 2021; 22:e934406
23 Feb 2022 : Case report
DOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250
17 Feb 2022 : Case report
DOI :10.12659/AJCR.934399
Am J Case Rep 2022; 23:e934399