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CASE REPORT
Spontaneous renal artery dissection masquerading as urinary tract infection
  1. Gajapathiraju Chamarthi,
  2. Abhilash Koratala,
  3. Rupam Ruchi
  1. Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Dr Abhilash Koratala, akoratsla{at}ufl.edu

Summary

Spontaneous renal artery dissection is a rare clinical entity, and symptoms vary from non-specific abdominal pain to life-threatening hypertension. A 44-year-old woman with no significant medical history initially presented with symptoms suggestive of urinary tract infection which did not respond to antibiotic therapy. Imaging revealed right renal infarction resulting from focal spontaneous renal artery dissection, which was managed conservatively. CT angiography is the preferred imaging modality for the diagnosis of this condition. Treatment options include medical management of hypertension with or without anticoagulation, endovascular intervention and surgical revascularisation depending on the presentation and the extent of the vascular and renal parenchymal involvement. This case emphasises the need to have high index of suspicion for uncommon diagnoses in patients who present with common symptoms but do not respond to empiric therapy.

  • hematuria
  • vascular surgery
  • renal medicine
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Footnotes

  • Contributors GC authored the initial draft. AK reviewed and revised the manuscript for critically important intellectual content. RR reviewed the manuscript; attending nephrologist on the case. *Both GC and AK have made equal contribution to the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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