Multiple arterial occlusions and hypertension probably caused by an oral contraceptive: a patient in whom the development of renovascular hypertension has been followed.

The case history of an 18-year-old patient who had been taking oral contraceptives for 2 years (ethinylestradiol 50 mcg megestrol acetate 4 mg) and who developed multiple arterial occlusions and hypertension is reported. Occlusion of the ceoliac artery was also found. The circumstances suggest that the occlusions were caused by multiple emboli of unknown source. The affected kidney was shown to have an abnormal renin secretion 3 and 6 months after the stroke but the peripheral renin level was lower at the 6 month investigation. A large degree of left ventricular hypertrophy was seen. Blood pressure was still uncontrolled despite antihypertensive therapy. Surgery was performed on the affected kidney and normal perfusion restored. The patient then became normotensive and has remained so for a 12-month period. Oral contraceptives were probably responsible for precipitating the vascular occlusion. Predisposing factors or warning symptoms were absent in this patient.