Misleading Diagnosis of Renal Artery Stenosis by Magnetic Resonance Angiography in a Patient with Primary Aldosteronism

Abstract

A 24-year-old woman presented with severe hypertension. A diagnostic evaluation for secondary hypertension was undertaken. A duplex ultrasonography followed by a magnetic angiography suspected fibromuscular dysplasia. Unexpectedly, a contrast-enhanced angiography performed for renal angioplasty showed normal renal arteries. Primary aldosteronism was then evoked on the basis of decreased plasma renin and increased plasma aldosterone and aldosterone/renin ratio. After a CT-scan disclosed a left adrenal tumour, the patient underwent a left laparoscopic adrenalectomy. Pathological findings confirmed a benign adrenocortical adenoma. Blood pressure and aldosterone levels were normalized after surgery. Thus, clinicians should be aware of false-positive results of magnetic resonance angiography that could hide other causes of secondary hypertension.

Additional information

Notes on contributors

V. Ippersiel

Dr. V. Ippersiel Service d’Endocrinologie Cliniques Universitaires UCL de Mont-Godinne Avenue G. Therasse, 1 5530 Yvoir, Belgium E-mail: [email protected]