Archives of Clinical Nephrology Citation: Ozturk S, Uysal M, Cosan F, Buyukaydin B, Inanc M, et al. (2016) Antiphosphlipid Syndrome Presented with Renovascular Hypertension. Arch Clin Nephrol 1(2): 037-038. 037 (95%) stenosis in let renal artery stent and over 50% stenosis in right renal artery. In-stent angioplasty for let renal artery was performed but an abdominal pain developed 10 days ater angioplasty and a perinephric hematoma was detected. Hematoma was removed with surgery but developed again and let nephrectomy was required. Because of postoperative hypervolemia and uraemia, hemodialysis was performed also. In patients’ follow-up, prolonged prothrombin time (PT), activated partial thromboplastin time (PTT) and thrombocytopenia were developed. Mixture test with equal quantity of patient’s plasma and normal plasma were performed at 0, 30, 60 and 120 minutes. No improvement was observed at any incubation period. Introduction Antiphospholipid syndrome (APS) is a disorder by reason of antiphospholipid antibodies such as anticardiolipin antibody (ACA) and lupus anticoagulant (LA), and it generally present with venous thromboses and recurrent miscarriages [1]. he kidneys are involved in 25% of the cases [2]. Renal artery stenosis was reported both in lupus-associated and primary APS [1,3]. We presented a fatal case of APS with perirenal hematoma. Case Report A 55-year-old female patient presented with headache, lank pain and dyspnea. She had hypertension for 6 years and let renal artery stenosis had been detected 2 years ago. Conventional angiography had revealed 90% and 45% narrowing in let and right renal artery respectively. A stent implantation was applied for let renal artery. She had been administered amlodipine, doxazosin and clopidogrel. In admission, she was incompatible with treatment and used only oral amlodipine and captopril but no clopidogrel. In physical examination pretibial edema was observed, blood pressure was 210/120 mmHg. A systolic murmur was present on the let side of umbilicus. he patients’ laboratory results are presented in Table 1. Magnetic resonance (MR) angiography revealed signiicant Case Report Antiphosphlipid Syndrome Presented with Renovascular Hypertension Savas Ozturk 1 , Mukremin Uysal 2 , Fulya Cosan 2 , Banu Buyukaydin³*, Murat Inanc 4 , Reyhan Diz-Kucukkaya 5 , Isın Kılıcarslan 6 , Aydin Turkmen 7 , Rumeyza Kazancioglu 8 1 Haseki Training and Research Hospital, Nephrology Istanbul, Turkey 2 Afyon Kocatepe University, Oncology, Afyon, Turkey 3 Afyon Kocatepe University, Rheumatology, Afyon, Turkey 4 Istanbul University, Rheumatology, Istanbul, Turkey 5 Florance Nightingale Hospital, Hematology, Istanbul, Turkey 6 Istanbul University, Pathology, Istanbul, Turkey 7 Istanbul Memorial Hospital, Nephrology, Istanbul, Turkey 8 Bezmialem Vakif University, Nephrology, Istanbul, Turkey Dates: Received: 23 May, 2016; Accepted: 15 June, 2016; Published: 16 June, 2016 *Corresponding author: Banu Buyukaydin, Bezmialem Vakif University, Faculty of Medicine, Internal Medicine, Adnan Menderes Street, 34093 Fatih / Istanbul, Turkey, Fax: +90 212 621 75 80; Tel: +90 212 453 17 10; E-mail: www.peertechz.com Keywords: Antiphospholipid syndrome; Chronic kidney disease; Renovascular hypertension Abstract Renovascular pathologies are one of the treatable causes of hypertension. Antiphospholipid syndrome develops owing to a heterogeneous group of antiphospholipid antibodies which causes various thrombotic problems. This entity may effects very small vessels and sometimes leads to hypertension. We present a 55-year-old female with unilateral renal artery stent implantation because of renovascular hypertension. After application, a re-stenosis developed and in-stent angioplasty was performed, but it was required a nephrectomy because of haemorrhage. Severe ischemic nephropathy was detected in the nephrectomy material. She was diagnosed with antiphospholipid syndrome. Prolonged prothrombin time with hemorrhagic diathesis which coexisting thrombosis responded steroid therapy. But in follow-up, the thrombocytopenia developed, the patient could not recieve anticoagulant therapy and died due to a pulmonary embolism-like syndrome. This case reminds, renovascular hypertension is one of the major reasons of secondary hypertension and antiphospholipid syndrome always should be considered in thrombotic processes. Table 1: Patients’ initial laboratory results. Patient’s results Normal values Erythrocyte sedimentation rate 30 0-20 mm/h Hemoglobin 9.8 11.5-16 g/dl Hematocrit 31 35-45% MCV 92 80-100 fL White blood cell 2750 4000-10000/mm³ Platelet 128000 150-400000/mm³ BUN 39 5-23 mg/dl Creatinine 1.5 0.6-1.2 mg/dl Proteinuria 1-2 g/day 150 mg/day Creatinine clearance 36 70-145 ml/day Urinalysis 10-15 erythrocytes 7-8 leucocytes and rare hyaline cylinders.