A Case Report Resistant hypertension as presenting manifestation of abdominal Takayasu’s Arteritis.

Abstract

Abstract Introduction: We report an unusual presentation of Takayasu’s Arteritis in young female with resistant hypertension to usual antihypertensive medication that discovered to extensive renal artery Case presentation: We report a 17 years old female with 2years history of hypertension that was difficult to control despite different type of antihypertension. Abdominal Ultrasound Abdominal us showed right kidney 12*5 cm, relatively small left kidney 8.3*3.8 cm, color duplex on normal low impedance flow in both renal and intrarenal arteries with no area of abnormal high velocity or damped flow. Investigation relieved ESR 50, CRP 26, ANA, ANCA serology were negative,S.NA 155, S.K 3.4, Serum aldosterone was 305 pg/ml (13.6-261.7) , renin activity was 254 pg/ml (4-45.98). The patient diagnosed as secondary hypertension to secondary hyperaldosternoism mostly renal artery stenosis, so CT angiography detected diffuse mural thickness with enhancement of the abdominal aorta and extending into proximal segments of superior and inferior mesenteric arteries, ostium of right renal artery and marked stenosis of the left renal artery (2 cm), relative small sized left kidney with hypo enhancement in comparison to the right kidney, finding suggestive to large vessel vasculitis, Takayasu’s Arteritis Conclusion: Resistant hypertension due to renal artery stenosis in young female can be a presenting manifestation of Takayasu’s Arteritis.