Unusual diffuse [131I]MIBG accumulation in a kidney with renal artery stenosis

(Section Editor: G. H. Neild) A 16‐year‐old woman was admitted for evaluation of hypertension. A CAT‐scan study showed an abnormal area in the upper pole of the right kidney or right suprarenal region. Technetium‐99m mercaptoacetyltriglycine (Tc‐99m MAG3) renogram was then performed. The right kidney showed no abnormalities, but in the entire left kidney there was a diffuse decrease of radiotracer perfusion and uptake, which was considered highly suggestive of left renal artery stenosis (Fig. 1). 131‐Iodine metaiodobenzylguanidine ([131I]MIBG scan was also performed because of clinical and radiographic suspicion of a pheochromocytoma in the right suprarenal region. The MIBG scan revealed abnormal tracer accumulation homogeneously distributed in the whole left kidney at 48 and 96 h but no abnormalities in the right renal or suprarenal area (Fig. 2). On the basis of Tc‐99m MAG3 and [131I]MIBG findings, this patient underwent selective angiography which confirmed an 80% stenosis of the lumen of the left renal artery.