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Renal manifestations in toddlers with Takayasu’s arteritis and malignant hypertension

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Abstract

Three children under the age of 3 years presented with malignant hypertension, proteinuria, and acute kidney injury. Takayasu’s arteritis was diagnosed on the basis of clinical symptoms of weight loss and low grade fever in conjunction with elevated sedimentation rate and radiographic evidence of aortic and renal artery stenosis. One patient had a renal biopsy which showed arteriolar sclerosis and focal glomerulosclerosis. All three patients required multiple antihypertensive agents, ultimately including angiotensin receptor blockers and/or angiotensin converting enzyme inhibitors. The vasculitis was treated with pulse corticosteroids followed by cyclophosphamide in one patient and mycophenolate mofetil as maintenance therapy in all. Follow-up has ranged from 2 to 8 years. Although global renal function has normalized in each patient, two have unilateral non-function of one kidney. The last patient has persistent aortic and renal artery stenosis with complex collateralization requiring ongoing medical and anticipated surgical management.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, University of Miami/Holtz Children’s Hospital, Miami, FL, USA

    Rana Hijazi, Jayanthi Chandar, Obioma Nwobi, Samina Muneeruddin, Gastón Zilleruelo & Carolyn L. Abitbol

  2. Pediatric Nephrology (M714), 1611 NW 12th Avenue, Annex 5, Miami, FL, 33126, USA

    Carolyn L. Abitbol

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  1. Rana Hijazi
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  2. Jayanthi Chandar
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  3. Obioma Nwobi
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  4. Samina Muneeruddin
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  5. Gastón Zilleruelo
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  6. Carolyn L. Abitbol
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Correspondence to Carolyn L. Abitbol.

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Hijazi, R., Chandar, J., Nwobi, O. et al. Renal manifestations in toddlers with Takayasu’s arteritis and malignant hypertension. Pediatr Nephrol 24, 1227–1230 (2009). https://doi.org/10.1007/s00467-008-1088-3

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  • DOI: https://doi.org/10.1007/s00467-008-1088-3

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