Complicación de la poliarteritis nodosa por síndrome de encefalopatía posterior reversible. Caso clínico

Alp, Alper; Akdam, Hakan; Akar, Harun; Koseoglu, Kutsi; Ozkul, Ayca; Meteoglu, Ibrahim; Yenicerioglu, Yavuz

doi:10.3265/Nefrologia.pre2014.Sep.12510

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La hipertensión es uno de los principales problemas de salud pública, que afecta a muchas personas en todo el mundo. Se sabe que es un importante factor de riesgo para el desarrollo de enfermedades cerebrovasculares y cardiovasculares. Su clasificación como “primaria” o “secundaria” depende del proceso subyacente. En el 5-10% de los pacientes hipertensos, se trata de un problema “secundario” a otro proceso de creciente frecuencia en los centros de atención terciaria. Las causas más frecuentes de la hipertensión secundaria son: enfermedades del parénquima renal, estenosis de la arteria renal, hiperaldosteronismo primario, feocromocitoma y el síndrome de Cushing. La poliarteritis nodosa puede afectar a cualquier órgano y en diferentes grados. A continuación presentamos a un paciente joven hipertenso al que se le ha diagnosticado poliarteritis nodosa, cuya angiografía muestra múltiples microaneurismas que afectan al tronco celíaco, a la arteria renal y a la arteria mesentérica superior, asociada a un síndrome de encefalopatía posterior reversible de entidad neurológica poco visto.

Palabras clave:

síndrome de encefalopatía posterior reversible

Palabras clave:

Insuficiencia renal

Palabras clave:

Hipertensión

Palabras clave:

Poliarteritis nodosa

Palabras clave:

Angiografía visceral

Hypertension (HT) represents a major public health problem affecting many individuals worldwide. It is well known to be an important risk factor for the development of cerebrovascular and cardiovascular diseases. Classifying hypertension as ‘primary’ or ‘secondary’ depends on the underlying mechanism. In 5 to 10% of hypertensive patients, HT develops ‘secondary’ to a separate mechanism that has been encountered with increasing frequency in the tertiary refferral centers. The frequent causes of secondary hypertension include renal parenchymal disease, renal artery stenosis, primary hyperaldosteronism, phaeochromocytoma and Cushing's syndrome. Polyarteritis nodosa (PAN) can involve any organ and in varying degrees. Here we present a young hypertensive patient diagnosed as PAN with the angiographic findings of multiple microaneurysms involving celiac, renal and superior mesenteric arteries and associated with a rarely seen neurological entity-PRES syndrome.

Keywords:

Posterior reversible encephalopathy syndrome

Keywords:

Renal failure

Keywords:

Hypertension

Keywords:

Polyarteritis nodosa

Keywords:

Visceral angiography

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