Renal infarction caused by medium vessel vasculitis

Vinothkumar Kavarthapol Jayaraman, Aron Chakera

Research output: Contribution to journalReview article

Abstract

A 44-year-old Italian man presented to the emergency department on three occasions over 4 days with severe left flank pain. Initial investigations including a renal tract ultrasound were normal and he was discharged with analgaesia. On his third presentation, a CT angiogram was performed due to persisting pain, which demonstrated infarction of his left kidney as well as thickening of the anterior branch of left renal artery and complete occlusion with focal intimal dissection of the coeliac artery. His antineutrophil cytoplasmic antibody was negative. A medium vessel vasculitis was suspected and confirmed on positron emission tomography-CT, which revealed increased metabolic activity involving the right internal mammary artery and coeliac artery. Treatment with pulse methylprednisolone was started followed by a tapering prednisolone regimen, with a rapid reduction in his inflammatory indices. Twenty-four months later his renal function remains normal off all immunosuppression.

Original languageEnglish
Article numberA629
JournalBMJ Case Reports
Volume2015
DOIs
Publication statusPublished - 24 Apr 2015
Externally publishedYes

Fingerprint

Vasculitis
Infarction
Celiac Artery
Kidney
Tunica Intima
Flank Pain
Antineutrophil Cytoplasmic Antibodies
Mammary Arteries
Methylprednisolone
Renal Artery
Prednisolone
Positron-Emission Tomography
Immunosuppression
Dissection
Hospital Emergency Service
Angiography
Pain
Therapeutics

Cite this

Kavarthapol Jayaraman, Vinothkumar ; Chakera, Aron. / Renal infarction caused by medium vessel vasculitis. In: BMJ Case Reports. 2015 ; Vol. 2015.
@article{530bbb581ac04750b483c23f1ed391b1,
title = "Renal infarction caused by medium vessel vasculitis",
abstract = "A 44-year-old Italian man presented to the emergency department on three occasions over 4 days with severe left flank pain. Initial investigations including a renal tract ultrasound were normal and he was discharged with analgaesia. On his third presentation, a CT angiogram was performed due to persisting pain, which demonstrated infarction of his left kidney as well as thickening of the anterior branch of left renal artery and complete occlusion with focal intimal dissection of the coeliac artery. His antineutrophil cytoplasmic antibody was negative. A medium vessel vasculitis was suspected and confirmed on positron emission tomography-CT, which revealed increased metabolic activity involving the right internal mammary artery and coeliac artery. Treatment with pulse methylprednisolone was started followed by a tapering prednisolone regimen, with a rapid reduction in his inflammatory indices. Twenty-four months later his renal function remains normal off all immunosuppression.",
keywords = "Adult, Anti-Inflammatory Agents, Celiac Artery, Flank Pain, Humans, Infarction, Kidney, Male, Mammary Arteries, Positron-Emission Tomography, Tomography, X-Ray Computed, Vasculitis, Case Reports, Journal Article",
author = "{Kavarthapol Jayaraman}, Vinothkumar and Aron Chakera",
note = "2015 BMJ Publishing Group Ltd.",
year = "2015",
month = "4",
day = "24",
doi = "10.1136/bcr-2014-208942",
language = "English",
volume = "2015",
journal = "B.M.J. Case Reports",
issn = "1757-790X",
publisher = "BMJ Publishing Group",

}

Renal infarction caused by medium vessel vasculitis. / Kavarthapol Jayaraman, Vinothkumar; Chakera, Aron.

In: BMJ Case Reports, Vol. 2015, A629, 24.04.2015.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Renal infarction caused by medium vessel vasculitis

AU - Kavarthapol Jayaraman, Vinothkumar

AU - Chakera, Aron

N1 - 2015 BMJ Publishing Group Ltd.

PY - 2015/4/24

Y1 - 2015/4/24

N2 - A 44-year-old Italian man presented to the emergency department on three occasions over 4 days with severe left flank pain. Initial investigations including a renal tract ultrasound were normal and he was discharged with analgaesia. On his third presentation, a CT angiogram was performed due to persisting pain, which demonstrated infarction of his left kidney as well as thickening of the anterior branch of left renal artery and complete occlusion with focal intimal dissection of the coeliac artery. His antineutrophil cytoplasmic antibody was negative. A medium vessel vasculitis was suspected and confirmed on positron emission tomography-CT, which revealed increased metabolic activity involving the right internal mammary artery and coeliac artery. Treatment with pulse methylprednisolone was started followed by a tapering prednisolone regimen, with a rapid reduction in his inflammatory indices. Twenty-four months later his renal function remains normal off all immunosuppression.

AB - A 44-year-old Italian man presented to the emergency department on three occasions over 4 days with severe left flank pain. Initial investigations including a renal tract ultrasound were normal and he was discharged with analgaesia. On his third presentation, a CT angiogram was performed due to persisting pain, which demonstrated infarction of his left kidney as well as thickening of the anterior branch of left renal artery and complete occlusion with focal intimal dissection of the coeliac artery. His antineutrophil cytoplasmic antibody was negative. A medium vessel vasculitis was suspected and confirmed on positron emission tomography-CT, which revealed increased metabolic activity involving the right internal mammary artery and coeliac artery. Treatment with pulse methylprednisolone was started followed by a tapering prednisolone regimen, with a rapid reduction in his inflammatory indices. Twenty-four months later his renal function remains normal off all immunosuppression.

KW - Adult

KW - Anti-Inflammatory Agents

KW - Celiac Artery

KW - Flank Pain

KW - Humans

KW - Infarction

KW - Kidney

KW - Male

KW - Mammary Arteries

KW - Positron-Emission Tomography

KW - Tomography, X-Ray Computed

KW - Vasculitis

KW - Case Reports

KW - Journal Article

UR - https://www.scopus.com/record/display.uri?eid=2-s2.0-84931271906&origin=resultslist&sort=plf-f&src=s&st1=

U2 - 10.1136/bcr-2014-208942

DO - 10.1136/bcr-2014-208942

M3 - Review article

VL - 2015

JO - B.M.J. Case Reports

JF - B.M.J. Case Reports

SN - 1757-790X

M1 - A629

ER -