Renovascular hypertension—is it fibromuscular dysplasia or Takayasu arteritis

  title={Renovascular hypertension—is it fibromuscular dysplasia or Takayasu arteritis},
  author={Kjell Tullus},
  journal={Pediatric Nephrology},
  • K. Tullus
  • Published 1 February 2013
  • Medicine
  • Pediatric Nephrology
Renovascular hypertension (RVH) can be caused by many different diseases, with the most common being fibromuscular dysplasia (FMD) and Takayasu arteritis (TA). A strikingly different diagnostic pattern is seen in children with RVH from different parts of the world. In Europe and North America, these children are mainly diagnosed as having FMD while in Asia and South Africa they will most often get a diagnosis of TA. When comparing the clinical diagnosis for FMD and TA, it becomes obvious that… 
Management of the renovascular disease in children with Takayasu arteritis
Patients with inactive disease have a more successful outcome and experience fewer complications from the intervention than those with active on-going inflammation.
Fibromuscular Dysplasia: From a Rare Cause of Renovascular Hypertension to a More Frequent Systemic Arterial Disease
The development of the US and European/International FMD registries and associated studies will undoubtedly shed new light on FMD and allow substantial progress in the understanding and management of the disease in the next decade.
An Update on Childhood-Onset Takayasu Arteritis
This article aims at providing a comprehensive review of childhood-onset TAK with a focus on recent publications, and recommends TNFα- or interleuking (IL)-6-inhibitors with improved disease control.
Posterior reversible encephalopathy syndrome caused by presumed Takayasu arteritis
A 5-year-old girl with presumed TA who presented with PRES and chronic total occlusion in the renal artery is reported, and the confirmatory diagnosis of TA was based on the pathologic findings of the renal arteries.
Angioplasty for recurrent renal artery stenosis in flare‐up of Hashimoto's thyroiditis
A 16‐year‐old girl presenting with RVH due to recurrent and novel RAS in Hashimoto's thyroiditis (HT) flare‐up is reported, and after treatment with thyroxin and percutaneous transluminal renal angioplasty (PTRA), she was free of hypothyroidism and systemic hypertension.
High prevalence of extrarenal artery involvement in children with fibromuscular dysplasia – a single-center experience
The results of this study suggest that pediatric FMD is a generalized arterial condition, and the patients may need screening for both renal as well as nonrenal manifestations of the disease.
Pitfalls in diagnosing and treating children with renal artery hypertension
The case presentation of a 12-year-old boy with hyponatremic hypertensive syndrome due to unilateral renovascular disease and the diagnosis of this child, which the authors give as Takayasu arteritis (TA), are worthwhile describing.
Differences between the pediatric and adult presentation of fibromuscular dysplasia: results from the US Registry
In the United States Registry for FMD, pediatric FMD affects children from infancy throughout childhood and in children, FMD most commonly affects the renal vasculature, but also frequently involves the mesenteric arteries and abdominal aorta.
[Renovascular disease in children - a rare diagnosis with few symptoms].
Children with severely elevated blood pressure as a result of renovascular disease often have unspecific or no symptoms and Invasive treatment may be considered in children and adolescents when standard treatment for hypertension is insufficient.
Clinical Course, Management, and Outcomes of Pediatric Takayasu Arteritis Initially Presenting with Hypertension: a 16-year overview.
Most of c-TA has hypertension, presenting with a more quiescent disease without typical systemic and/or ischemia symptoms, more localized abdominal lesions, higher proportion of revascularizations and better event-free survival.


Diagnosis, management, and future developments of fibromuscular dysplasia.
Large vessel vasculitis
The condition should be considered in patients with unexplained arterial hypertension or unexplained inflammatory syndromes without signs of localization, and patients with persistent ischaemic symptoms including hypertension might benefit from revascularization procedures.
Takayasu Arteritis
The clinical manifestations, treatment, and long-term outcome of patients with Takayasu arteritis are reported, which is the largest cohort of patients thus far studied in the United States.
Fibromuscular dysplasia
Percutaneous angioplasty has emerged as the preferred treatment for symptomatic cerebrovascular FMD and antiplatelet agents represent the cornerstone of therapy.
Angiographic features of 26 children with Takayasu's arteritis
The angiographic features and pattern of aortic involvement is essential for diagnosis and initiation of early and appropriate treatment, including PTA, in children with Takayasu's arteritis.
Takayasu arteritis: key clinical factors for early diagnosis
The challenge for the clinician is to consider Takayasu arteritis during the early phase when the symptoms are non-specific and often systemic, making a timely diagnosis difficult.
Morphology of fibromuscular dysplasia of the renal artery in renovascular hypertension.
Spectrum of renal findings in pediatric fibromuscular dysplasia and neurofibromatosis type 1
This study characterizes renal angiographic findings in pediatric fibromuscular dysplasia (FMD) and neurofibromatosis type 1(NF1) and provides a descriptive characterization of renal angiologist findings in these patients.
Renovascular disease in childhood.
A review of Takayasu’s arteritis in children in Gauteng, South Africa
It is shown that with active medical and surgical intervention the aggressive course of Takayasu's arteritis in children can be modified.