January 2000, Volume 9, Issue 1, Pages 65 – 67

Case report

A reversible bilateral renal artery stenosis in association with Antiphospholipid Syndrome GI Remondino1, E Mysler1, MN Pissano2, MC Furattini1, MC Basta1, JL Presas1 & A Allievi1 1Autoimmune Diseases Group, Internal Medicine B, Hospital Juan A. Fernández, Buenos Aires, Argentina     2Nephrology Department, Hospital Penna, Buenos Aires, Argentina     Correspondence to: Dr. GI Remondino , Internal Medicine B, Hospital Juan A Fernández, Cervino 3356-1425, Buenos Aires,Argentina. E-mail: groremon@fibertal.com.ar ; Fax: 54 11 48161054

Keywords

antiphospholipid syndrome;   renal artery stenosis;   acenocumarol

Abstract

We describe a 26-year-old white female with a history of Raynaud phenomenon, erythema nodosum, polyarthralgias, migraine, vertigo, seizures, transient ischemic attacks, one fetal loss, and false positive VDRL, who developed milk hypertension without overt lupus nephritis. She had positive antinuclear antibodies (ANA) and double-stranded deoxyribonucleic acid (dsDNA) antibodies. The lupus anticoagulant test (LAC) and cardiolipins antibodies (aCL) were positive. She was diagnosed as having a Systemic Lupus Erythematosus-like illness (SLE-like) with ‘secondary’ antiphospholipid syndrome (APS). Renal spiral computed tomography (CT) with intravenous (IV) contrast showed bilateral renal artery stenosis. Anticoagulation with acenocumarol was started. She became normotensive without antihypertensive drugs five months later. A follow-up renal spiral CT showed complete recanalization of both renal arteries, making thrombosis the more likely culprit pathology in the stenosis. After two years follow up the patient is normotensive. She remains on acenocumarol. Lupus (2000) 9, 65-67

Received 7 April 1999; Accepted 15 September 1999

^© Macmillan Publishers Ltd 1997