The importance of MSCT examination in the diagnosis and monitoring of renovascular hypertension as a consequence of renal artery occlusion in a patient with thrombophilia

Renovascular hypertension is a common cause of secondary hypertension, most frequently triggered by atherosclerotic changes in the renal arteries. However, during the diagnostic process, it is essential to consider other potential causes such as vasculitis, external compression, or direct arterial occlusion. Multislice computed tomography (MSCT) with contrast plays a key role in visualizing the renal arteries and evaluating the renal parenchyma. In the presented case, a patient with abdominal pain and a positive family history of hypertension underwent MSCT, which revealed ischemic areas in the left kidney and occlusive lesions of the left renal artery. Laboratory findings showed elevated C-reactive protein (CRP). Following initial treatment with fraxiparine and stabilization, the patient was discharged, but due to recurring symptoms, he returned to the emergency department, where imaging findings remained unchanged. Additional laboratory tests (ANCA, anti-cardiolipin antibodies) were negative, but thrombophilic mutations (XIII V34L, PAI-1, and MTHFR) were identified. Throughout the evaluation, renal function remained preserved. In conclusion, MSCT demonstrated high diagnostic value in assessing renovascular pathology and consequent hypertension, allowing for the detection and monitoring of vascular changes and renal damage.