Renal manifestations in toddlers with Takayasu's arteritis and malignant hypertension

Rana Hijazi, Jayanthi Chandar, Obioma Nwobi, Samina Muneeruddin, Gastón Zilleruelo, Carolyn L. Abitbol

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Three children under the age of 3 years presented with malignant hypertension, proteinuria, and acute kidney injury. Takayasu's arteritis was diagnosed on the basis of clinical symptoms of weight loss and low grade fever in conjunction with elevated sedimentation rate and radiographic evidence of aortic and renal artery stenosis. One patient had a renal biopsy which showed arteriolar sclerosis and focal glomerulosclerosis. All three patients required multiple antihypertensive agents, ultimately including angiotensin receptor blockers and/or angiotensin converting enzyme inhibitors. The vasculitis was treated with pulse corticosteroids followed by cyclophosphamide in one patient and mycophenolate mofetil as maintenance therapy in all. Follow-up has ranged from 2 to 8 years. Although global renal function has normalized in each patient, two have unilateral non-function of one kidney. The last patient has persistent aortic and renal artery stenosis with complex collateralization requiring ongoing medical and anticipated surgical management.

Original languageEnglish (US)
Pages (from-to)1227-1230
Number of pages4
JournalPediatric Nephrology
Volume24
Issue number6
DOIs
StatePublished - Jan 1 2009

Keywords

  • Children
  • Renovascular hypertension
  • Vasculitis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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