Hypertension due to renal artery occlusion in a patient with antiphospholipid syndrome

We report an unusual case of renovascular hypertension in a 16-year-old boy with primary antiphospholipid syndrome (PAPS), admitted to our clinic for severe drug-resistant hypertension and hypokalemia. Hormonal investigation revealed secondary aldosteronism and positive captopril test for renovascul ar disease. Aortography confirmed the occlusion of the left renal artery. A fter nephrectomy, normalization of blood pressure and secondary aldosteroni sm occurred. Presently the patient remains in good health, receiving warfar in anticoagulant therapy. PAPS is defined by the presence of antiphospholip id antibodies and recurrent thrombosis. Arterial thrombosis (29%) appears t o be less prevalent than venous thrombosis. Thrombotic microangiopathy of t he kidney is frequently observed but renal artery occlusion, as seen in our patient, is unusual. (C) 2001 American Journal of Hypertension, Ltd.