Fibromuscular dysplasia of renal arteries presenting with bilateral renal infarction in a young man.

Fibromuscular dysplasia (FMD) describes a group of conditions which cause nonatheromatous arterial ste- noses, most commonly of the renal and carotid arter- ies, typically in young women. We report the case of a previously healthy 43-year-old white man presenting with acute bilateral flank pain. The pain was more se- vere on the left side. Initially treated for ureteral colic, he was transferred to the nephrology unit upon rec- ognition of a rising serum creatinine. He was found to have FMD of bilateral renal arteries with resultant infarctions in both kidneys. He was treated with in- travenous heparin and, then, warfarin at discharge. At a 16-month review, the patient remained pain-free with normal renal function and with antiplatelet and dual antihypertensive therapy. In conclusion, renal infarction complicating FMD is rare, with most cases involving causative cardiovascular risk factors, in- cluding coagulopathy, ischemic heart disease, atrial fibrillation or structural cardiac abnormalities, none of which was present in this case. What makes this case interesting are the clinically significant bilateral renal infarctions due to atypical asymmetric FMD in both kidneys in a young man.