A case of hypertensive emergency with alveolar hemorrhage and thrombotic microangiopathy.
Yoshifumi UbaraShigekazu KuriharaYoshiki TsuchiyaYuki ObaDaisuke IkumaHiroki MizunoMasayuki YamanouchiTatsuya SuwabeAtsuko ImaseNobumitsu ShibataKei KonoKeiichi KinowakiKenichi OhashiKentaro OgataNaoki SawaPublished in: CEN case reports (2024)
A 28-year-old woman with a 5-year history of untreated hypertension was admitted for respiratory distress, hemoptysis, and retinopathy. Computed tomography showed diffuse plaques in both lung fields. Acute kidney injury, hemolytic anemia, and thrombocytopenia were noted. Kidney biopsy showed thrombosis with fibrinoid necrosis and edematous intimal thickening and luminal narrowing of the small renal artery, indicating thrombotic microangiopathy; the majority of glomeruli were collapsed. After 8 weeks of treatment with antihypertensive drugs, serum creatinine decreased to 1.0 mg/dL, and the patient recovered. In the absence of any other underlying disease, malignant nephrosclerosis associated with a hypertensive emergency was diagnosed.
Keyphrases
- blood pressure
- acute kidney injury
- computed tomography
- public health
- emergency department
- hypertensive patients
- healthcare
- pulmonary embolism
- cardiac surgery
- chronic kidney disease
- magnetic resonance imaging
- positron emission tomography
- case report
- low grade
- uric acid
- ultrasound guided
- emergency medical
- magnetic resonance
- fine needle aspiration
- combination therapy
- image quality
- high grade
- drug induced
- smoking cessation
- pet ct