A young man with a renal colic
Article first published online: 27 NOV 2003
Journal of Internal Medicine
Volume 254, Issue 6, pages 605–608, December 2003
How to Cite
Barbey, F., Matthieu, C., Nseir, G., Burnier, M. and Teta, D. (2003), A young man with a renal colic. Journal of Internal Medicine, 254: 605–608. doi: 10.1111/j.1365-2796.2003.01214.x
- Issue published online: 27 NOV 2003
- Article first published online: 27 NOV 2003
- Received 12 January 2003; revision received 5 May 2003; accepted 28 May 2003.
- fibromuscular dysplasia;
- renal infarction;
We report the case of a 35-year-old man with no cardiovascular morbidity, presenting with acute flank pain, microscopic haematuria and normal blood pressure. Initially diagnosed as a ureteral colic, the patient was recovered 6 weeks later with severe hypertensive crisis. Further investigations revealed a massive renal infarction secondary to medial fibromuscular dysplasia (FMD). Several aspects of this presentation are intriguing. Renal infarcts are usually seen in older patients having cardiac problems and/or major atheromatous plaques. In addition, FMD is mainly observed in young females and rarely progresses to renal artery occlusion. Furthermore, in this case, FMD remained silent until the acute renal infarction occurred, despite a significant kidney size reduction at the time of diagnosis. Finally, the observation of a delayed hypertensive response to a major renovascular insult provides incentives to discuss possible pathophysiological mechanisms involved in renovascular hypertension.