Abi Doumet Amanda, Bustos Brian, Garrell Jacob, Salman Momina, Haider Lalarukh
Internal Medicine, University of Connecticut, Farmington, USA.
Primary Care Internal Medicine, University of Connecticut, Farmington, USA.
Cureus. 2023 Mar 9;15(3):e35933. doi: 10.7759/cureus.35933. eCollection 2023 Mar.
Fibromuscular dysplasia (FMD) is a rare systemic vascular disease that has been found to present as a renal infarction (RI) in only a handful of cases. We present a case of a 53-year-old Vietnamese patient presenting for sharp, severe left-sided abdominal pain of two-day duration associated with a migraine headache. On presentation, she was afebrile, and her vital signs were stable. Laboratory investigations were significant for mildly elevated leukocytosis but were otherwise normal. CT abdomen and pelvis with contrast revealed a left-sided renal infarct. The patient was then admitted to the hospital and started on therapeutic anticoagulation. A transthoracic echocardiogram was obtained and revealed no vegetation. CT angiography of the abdomen was pursued and was significant for mild beading within the mid-right and left renal arteries, consistent with fibromuscular dysplasia. Our patient was diagnosed with renal infarction in the setting of fibromuscular dysplasia, a combination that has been reported only a few times. Interestingly, our patient also had mild FMD based on imaging, making it even more of an unusual cause of renal infarction. This case highlights the connection between these two diseases and the need for more studies to characterize the association between them.
纤维肌发育异常（FMD）是一种罕见的系统性血管疾病，仅在少数病例中被发现表现为肾梗死（RI）。我们报告一例53岁越南患者，因持续两天的剧烈左侧腹痛就诊，伴有偏头痛。就诊时，她无发热，生命体征稳定。实验室检查显示白细胞轻度升高，但其他方面正常。腹部和盆腔增强CT显示左侧肾梗死。该患者随后入院并开始接受抗凝治疗。进行了经胸超声心动图检查，未发现赘生物。随后进行了腹部CT血管造影，结果显示右肾动脉中段和左肾动脉轻度串珠样改变，符合纤维肌发育异常。我们的患者被诊断为纤维肌发育异常背景下的肾梗死，这种组合仅被报道过几次。有趣的是，根据影像学检查，我们的患者还患有轻度FMD，这使得它成为肾梗死更不寻常的病因。本病例突出了这两种疾病之间的联系以及开展更多研究以明确它们之间关联的必要性。
