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Spontaneous renal artery dissection in Ehlers-Danlos syndrome

엘러스-단로스 증후군에 발생한 자발성 신장동맥 박리

  • Lim, Byung-Hun (Department of Internal Medicine, Wonkwang University School of Medicine) ;
  • Lee, Song-I (Department of Internal Medicine, Wonkwang University School of Medicine) ;
  • Lim, Jae-Hong (Department of Internal Medicine, Wonkwang University School of Medicine) ;
  • Oh, Su-Jin (Department of Internal Medicine, Wonkwang University School of Medicine) ;
  • Chu, Min-Su (Department of Internal Medicine, Wonkwang University School of Medicine) ;
  • Ahn, Seon-Ho (Department of Internal Medicine, Wonkwang University School of Medicine) ;
  • Byun, Seung-Jae (Department of Surgery, Wonkwang University School of Medicine)
  • 임병훈 (원광대학교 의과대학 내과학교실) ;
  • 이송이 (원광대학교 의과대학 내과학교실) ;
  • 임재홍 (원광대학교 의과대학 내과학교실) ;
  • 오수진 (원광대학교 의과대학 내과학교실) ;
  • 주민수 (원광대학교 의과대학 내과학교실) ;
  • 안선호 (원광대학교 의과대학 내과학교실) ;
  • 변승재 (원광대학교 의과대학 외과학교실)
  • Received : 2014.12.11
  • Accepted : 2015.03.19
  • Published : 2016.06.30

Abstract

Primary dissection of the renal artery is rare. Spontaneous renal artery dissection can be associated with diseases such as medial degeneration, neurofibromatosis, syphilitic arteritis, tuberculosis, polyarteritis nodosa, Marfan syndrome, fibromuscular dysplasia, or Ehlers-Danlos syndrome (EDS). Among these causes, EDS related renal artery dissection is very rare worldwide and has not been previously reported in Korea. EDS are a group of heritable connective tissue disorders characterized by fragility of the skin and hypermobility of the joints. We describe the case history of a young man who presented with left side flank pain, hypermobility of the hand joints and showed left renal artery dissection on computed tomography and angiography that turned out to be the first complication of vascular type EDS.

Keywords

References

  1. Wooley CF, Sparks EH, Hirata K, Boudoulas H. The aortopathy of heritable cardiovascular disease. In: Functional abnormalities of the aorta. Armonk, NY: Futura Publishing; 1996. p. 295-320.
  2. Esayag-Tendler B, Yamase H, Ramsby G, White WB. Accelerated hypertension with encephalopathy due to an isolated dissection of a renal artery branch vessel. Am J Kidney Dis 1994;23:869-73. https://doi.org/10.1016/S0272-6386(12)80143-0
  3. Beighton P, De Paepe A, Steinmann B, Tsipouras P, Wenstrup RJ. Ehlers-Danlos syndromes: revised nosology, Villefranche, 1997. Ehlers-Danlos National Foundation (USA) and Ehlers-Danlos Support Group (UK). Am J Med Genet 1998;77:31-7. https://doi.org/10.1002/(SICI)1096-8628(19980428)77:1<31::AID-AJMG8>3.0.CO;2-O
  4. Germain DP. Ehlers-Danlos syndrome type IV. Orphanet J Rare Dis 2007;2:32. https://doi.org/10.1186/1750-1172-2-32
  5. Pepin M, Schwarze U, Superti-Furga A, Byers PH. Clinical and genetic features of Ehlers-Danlos syndrome type IV, the vascular type. N Engl J Med 2000;342:673-80. https://doi.org/10.1056/NEJM200003093421001
  6. Zilocchi M, Macedo TA, Oderich GS, Vrtiska TJ, Biondetti PR, Stanson AW. Vascular Ehlers-Danlos syndrome: imaging findings. AJR Am J Roentgenol 2007;189:712-9. https://doi.org/10.2214/AJR.07.2370
  7. Park JK. Ehlers-Danlos syndrome type IV and the management of its vascular complication. Korean J Vasc Endovasc Surg 2011;27:47-51. Korean.
  8. Oderich GS, Panneton JM, Bower TC, Lindor NM, Cherry KJ, Noel AA, et al. The spectrum, management and clinical outcome of Ehlers-Danlos syndrome type IV: a 30-year experience. J Vasc Surg 2005;42:98-106. https://doi.org/10.1016/j.jvs.2005.03.053
  9. Okada T, Frank M, Pellerin O, Primio MD, Angelopoulos G, Boughenou MF, et al. Embolization of life-threatening arterial rupture in patients with vascular Ehlers-Danlos syndrome. Cardiovasc Intervent Radiol 2014;37:77-84. https://doi.org/10.1007/s00270-013-0640-0
  10. Casana R, Nano G, Dalainas I, Tealdi DG. Endovascular treatment of hepatic artery aneurysm in a patient with Ehlers-Danlos syndrome. Case report. Int Angiol 2004;23:291-5.
  11. Tonnessen BH, Sternbergh WC 3rd, Mannava K, Money SR. Endovascular repair of an iliac artery aneurysm in a patient with Ehlers-Danlos syndrome type IV. J Vasc Surg 2007;45:177-9. https://doi.org/10.1016/j.jvs.2006.08.071
  12. Khalique Z, Lyons OT, Clough RE, Bell RE, Reidy JF, Schwarze U, et al. Successful endovascular repair of acute type B aortic dissection in undiagnosed Ehlers-Danlos syndrome type IV. Eur J Vasc Endovasc Surg 2009;38:608-9. https://doi.org/10.1016/j.ejvs.2009.07.009
  13. Raval M, Lee CJ, Phade S, Riaz A, Eskandari M, Rodriguez H. Covered stent use after subclavian artery and vein injuries in the setting of vascular Ehlers-Danlos. J Vasc Surg 2012;55:542-4. https://doi.org/10.1016/j.jvs.2011.08.002