Misleading diagnosis of renal artery stenosis by magnetic resonance angiography in a patient with primary aldosteronism.

Ippersiel, Vanessa;Rosière, Alain;Michel, Luc;Donckier, Julian
(2012) Acta Chirurgica Belgica (Bilingual Edition) — Vol. 112, n° 4, p. 302-306 (2012)

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Abstract
A 24-year-old woman presented with severe hypertension. A diagnostic evaluation for secondary hypertension was undertaken. A duplex ultrasonography followed by a magnetic angiography suspected fibromuscular dysplasia. Unexpectedly, a contrast-enhanced angiography performed for renal angioplasty showed normal renal arteries. Primary aldosteronism was then evoked on the basis of decreased plasma renin and increased plasma aldosterone and aldosterone/renin ratio. After a CT-scan disclosed a left adrenal tumour, the patient underwent a left laparoscopic adrenalectomy. Pathological findings confirmed a benign adrenocortical adenoma. Blood pressure and aldosterone levels were normalized after surgery. Thus, clinicians should be aware of false-positive results of magnetic resonance angiography that could hide other causes of secondary hypertension.
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Ippersiel, V., Rosière, A., Michel, L., & Donckier, J. (2012). Misleading diagnosis of renal artery stenosis by magnetic resonance angiography in a patient with primary aldosteronism. Acta Chirurgica Belgica (Bilingual Edition), 112(4), 302-306. https://hdl.handle.net/2078.5/36813 (Original work published 2012)