SHOULD AN ACCESSORY RENAL ARTERY BE CONSIDERED AS A CAUSE OF HYPERTENSION IN ADOLESCENTS: A CASE REPORT.

The role of an accessory renal artery in the pathogenesis of hypertension is still controversial. In this report, we describe a previously healthy 16-year-old girl with an accessory right renal artery who presented with hypertensive urgency (no progressive target organ dysfunction). Initial workup other than hypercholesterolemia and mild proteinuria was normal with no signs of other target organ damage. Further evaluation was aimed at determining the possible cause of secondary hypertension. High normal plasma renin with elevated plasma aldosterone led to a suspicion of renovascular hypertension. Magnetic resonance angiography and later computed tomography angiography showed two non-stenotic right renal arteries. Another diagnostic workup was normal. A satisfactory blood pressure control was eventually achieved with combination therapy including angiotensin-converting enzyme inhibitor. We conclude that although non-stenotic, an accessory renal artery should be considered as a possible cause of renovascular hypertension in children and adolescents even in the absence of hyperreninemia.