Renal Artery Occlusion, Malignant Hypertension and Thrombotic Thrombocytopenic Purpura

Abstract.A case with unilateral renal artery stenosis and malignant hypertension, complicated with thrombotic thrombocytopenic purpura (TTP), is described. The patient was uraemic due to severe arteriolar sclerosis in the contralateral kidney. A massive consumption of platelets, a decreased fibrinogen value and occurrence of fibrin/fibrinogen degradation products (FDP) in serum and urine were demonstrated. During treatment with heparin the renal function improved, the platelet count rose and the FDP amount in the serum as well as in the urine decreased. Reconstructive surgery of the occluded artery was then performed and the contralateral kidney was removed.