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A reversible bilateral renal artery stenosis in association with Antiphospholipid Syndrome

Autoimmune Diseases Group, Internal Medicine B, Hospital Juan A. Fernández, Buenos Aires, Argentina; Internal Medicine B, Hospital Juan A Fernández, Cervino 3356-1425, Buenos Aires, Argentina, groremon{at}fibertal.com.ar; Fax: 54 11 4816 1054

E Mysler

Autoimmune Diseases Group, Internal Medicine B, Hospital Juan A. Fernández, Buenos Aires, Argentina

M N Pissano

Nephrology Department, Hospital Penna, Buenos Aires, Argentina

M C Furattini

M C Basta

J L Presas

A Allievi

Autoimmune Diseases Group, Internal Medicine B, Hospital Juan A. Fernández, Buenos Aires, Argentina

We describe a 26-year-old white female with a history of Raynaud phenomenon, erythema nodosum, polyarthralgias, migraine, vertigo, seizures, transient ischemic attacks, one fetal loss, and false positive VDRL, who developed milk hypertension without overt lupus nephritis. She had positive antinuclear antibodies (ANA) and double-stranded deoxyribonucleic acid (dsDNA) antibodies. The lupus anticoagulant test (LAC) and cardiolipins antibodies (aCL) were positive. She was diagnosed as having a Systemic Lupus Erythematosus-like illness (SLE-like) with ‘secondary’ antiphospholipid syndrome (APS). Renal spiral computed tomography (CT) with intravenous (IV) contrast showed bilateral renal artery stenosis. Anticoagulation with acenocumarol was started. She became normotensive without antihypertensive drugs five months later. A follow-up renal spiral CT showed complete recanalization of both renal arteries, making thrombosis the more likely culprit pathology in the stenosis. After two years follow up the patient is normotensive. She remains on acenocumarol.

Key Words: antiphospholipid syndrome • renal artery stenosis • acenocumarol

Lupus, Vol. 9, No. 1, 65-67 (2000)
DOI: 10.1177/096120330000900112


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