Park S H, Chi J G, Choi Y
Department of Pathology and Pediatrics, Seoul National University Children's Hospital, Korea.
Child Nephrol Urol. 1990;10(1):51-5.
Although fibromuscular dysplasia (FMD) rarely occurs, it is the most common cause of renal artery disease in children. Aneurysm formation in FMD is well documented in adults. However, it was rarely described in children, partly because medial fibroplasia with a tendency to aneurysm formation is relatively rare. This report describes a 7-year-old girl with very unusual sets of abnormalities involving the left renal artery. Intimal fibroplasia with multiple small saccular aneurysms was seen. She presented with recent-onset renovascular hypertension, headache and intermittent severe colicky abdominal pain. Angiography revealed multifocal stenosis with multiple aneurysms of the left renal artery. Renal vein renin was twice as high on the involved side than on the contralateral side. After nephrectomy, the hypertension was under control without medication.
尽管纤维肌性发育异常(FMD)很少见,但它是儿童肾动脉疾病最常见的病因。FMD中动脉瘤形成在成人中有充分记录。然而,在儿童中很少有描述,部分原因是具有动脉瘤形成倾向的中膜纤维增生相对少见。本报告描述了一名7岁女孩,其左肾动脉存在非常不寻常的异常情况。可见内膜纤维增生伴多发小囊状动脉瘤。她出现了近期发作的肾血管性高血压、头痛和间歇性严重绞痛性腹痛。血管造影显示左肾动脉多处狭窄伴多发动脉瘤。患侧肾静脉肾素水平是对侧的两倍。肾切除术后,高血压无需药物治疗即可得到控制。