Article: article from journal or magazin.
Case report (case report): feedback on an observation with a short commentary.
A young man with a renal colic
Journal of Internal Medicine
Case Reports Journal Article --- Old month value: Dec
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.
Adult Colic/*etiology Diagnosis, Differential Fibromuscular Dysplasia/*complications/diagnosis Flank Pain/etiology Humans Infarction/complications Kidney/blood supply Kidney Diseases/*etiology Male Urinary Calculi/diagnosis
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