Localized renal artery vasculopathy: avoiding misdiagnosis between inflammatory arteritis and isolated renal artery dissection.
Sopie Secka, Ilaria Calciolari, Beatrice Maranini et al.
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Case in brief
Two cases of unilateral renal artery pathology were initially misdiagnosed as vasculitis. The first case involved a 47-year-old man with acute flank pain, where imaging revealed perivascular tissue and a pseudoaneurysm, leading to a diagnosis of localized idiopathic fibro-inflammatory arteritis after corticosteroid treatment. The second case involved a 42-year-old man with sudden hypertension and renal ischemia, ultimately diagnosed with spontaneous renal artery dissection confirmed by angiography, managed conservatively.
Diagnostic / clinical pearl
Normal or mildly elevated inflammatory markers do not exclude localized vascular inflammation, necessitating advanced imaging and angiography for accurate diagnosis.
Why it matters
Misdiagnosis between inflammatory arteritis and isolated renal artery dissection can lead to inappropriate treatment, highlighting the importance of a multidisciplinary approach in evaluation.