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- W1857155809 abstract "An et al. Clin Cardiol. 2013;36:E7–E10. An et al1 reported in their recent article an interesting case of a young male hypertensive patient with proteinuria, creatinine, and blood urea nitrogen levels within normal range. The patient had a single kidney with multiple stenotic lesions documented by Doppler ultrasound, computed tomography scan, and then with arteriography. Angiography revealed diffuse narrowing in the branches of renal artery. In addition, he presented with a slight elevation of C-reactive protein (1.9 mg/dL). The authors suspected a renal fibromuscular dysplasia (FMD) and successfully treated the patient by angioplasty with an excellent clinical and radiological outcome. However, we have some considerations. FMD is defined as an idiopathic, segmental, nonatheromatous disease of the musculature of the arterial wall leading to stenosis of small and medium-sized arteries. It is characterized by elastic fiber loss, proliferation of smooth muscle cells, and fibrous tissue deposition.2 FMD most commonly affects the renal and carotid arteries but has been observed in almost every artery in the body. Either stenosis, aneurysm, dissection, and occlusion may occur, or the patient may be entirely asymptomatic. FMD occurs most frequently in females between the ages of 20 and 60 years but may also be observed in males or older individuals. Renal artery FMD occurs in approximately 75% of patients with FMD and is bilateral in 35% of patients. Extracranial cerebrovascular FMD most commonly occurs in the internal carotid artery near the level of C1-C2. There is an increased prevalence of intracranial aneurysms in patients with extracranial cerebrovascular FMD compared with the general population. The differential diagnosis is between atherosclerotic stenosis, vasculitis, and segmental arterial mediolysis. An association of FMD has been observed with other arterial diseases such as Marfan syndrome, Takayasu arteritis, neurofibromatosis type I, and Ehlers-Danlos syndrome type IV (vascular type).3, 4 Did the authors suspect any possible different etiology of renal artery stenosis (vasculitis, collagenopathies)? Were other sites of arterial disease excluded in the patient? Antonio Bozzani, MD Alessia Moia, MD Marianna Carlino, MD Marco Caldana, MD Franco Ragni, MD Department of Vascular Surgery Foundation I.R.C.C.S. Policlinico San Matteo Pavia, Italy" @default.
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- W1857155809 date "2013-10-17" @default.
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- W1857155809 title "Response to Fibromuscular Dysplasia Affecting a Two-Branched Renal Artery in a Patient With a Solitary Kidney: Case Presentation" @default.
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- W1857155809 doi "https://doi.org/10.1002/clc.22221" @default.
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