A reversible bilateral renal artery stenosis in association with Antiphospholipid Syndrome

We describe a 26-year-old white female with a history of Raynaud phenomenon , erythema nodosum, polyarthralgias, migraine, vertigo, seizures, transient ischemic attacks, one fetal loss, and false positive VDRL, who developed m ilk hypertension without overt lupus nephritis. She had positive antinuclea r antibodies (ANA) and double-stranded deoxyribonucleic acid (dsDNA) antibo dies. The lupus anticoagulant test (LAC) and cardiolipins antibodies (aCL) were positive. She was diagnosed as having a Systemic Lupus Erythematosus-l ike illness (SLE-like) with 'secondary' antiphospholipid syndrome (APS). Re nal spiral computed tomography (CT) with intravenous (IV) contrast showed b ilateral renal artery stenosis. Anticoagulation with acenocumarol was start ed. She became normotensive without antihypertensive drugs five months late r. A follow-up renal spiral CT showed complete recanalization of both renal arteries, making thrombosis the more likely culprit pathology in the steno sis. After two years follow up the patient is normotensive. She remains on acenocumarol.