A case of hypertensive emergency with alveolar hemorrhage and thrombotic microangiopathy.

IF 0.7 Q4 UROLOGY & NEPHROLOGY CEN Case Reports Pub Date : 2024-12-01 Epub Date: 2024-03-28 DOI:10.1007/s13730-024-00863-5
Yoshifumi Ubara, Shigekazu Kurihara, Yoshiki Tsuchiya, Yuki Oba, Daisuke Ikuma, Hiroki Mizuno, Masayuki Yamanouchi, Tatsuya Suwabe, Atsuko Imase, Nobumitsu Shibata, Kei Kono, Keiichi Kinowaki, Kenichi Ohashi, Kentaro Ogata, Naoki Sawa
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Abstract

A 28-year-old woman with a 5-year history of untreated hypertension was admitted for respiratory distress, hemoptysis, and retinopathy. Computed tomography showed diffuse plaques in both lung fields. Acute kidney injury, hemolytic anemia, and thrombocytopenia were noted. Kidney biopsy showed thrombosis with fibrinoid necrosis and edematous intimal thickening and luminal narrowing of the small renal artery, indicating thrombotic microangiopathy; the majority of glomeruli were collapsed. After 8 weeks of treatment with antihypertensive drugs, serum creatinine decreased to 1.0 mg/dL, and the patient recovered. In the absence of any other underlying disease, malignant nephrosclerosis associated with a hypertensive emergency was diagnosed.

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一例伴有肺泡出血和血栓性微血管病的高血压急症。
一名 28 岁的女性因呼吸困难、咯血和视网膜病变入院,她有 5 年的高血压病史,一直未得到治疗。计算机断层扫描显示,患者双肺区域出现弥漫性斑块。患者出现急性肾损伤、溶血性贫血和血小板减少。肾活检显示血栓形成,伴有纤维素性坏死、水肿性内膜增厚和肾小动脉管腔狭窄,表明存在血栓性微血管病;大部分肾小球塌陷。经过 8 周的降压药物治疗后,血清肌酐降至 1.0 毫克/分升,患者痊愈。在没有任何其他基础疾病的情况下,诊断为与高血压急症相关的恶性肾硬化。
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来源期刊
CEN Case Reports
CEN Case Reports UROLOGY & NEPHROLOGY-
CiteScore
1.90
自引率
0.00%
发文量
80
期刊介绍: Clinical and Experimental Nephrology (CEN) Case Reports is a peer-reviewed online-only journal, officially published biannually by the Japanese Society of Nephrology (JSN).  The journal publishes original case reports in nephrology and related areas.  The purpose of CEN Case Reports is to provide clinicians and researchers with a forum in which to disseminate their personal experience to a wide readership and to review interesting cases encountered by colleagues all over the world, from whom contributions are welcomed.
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