Case Report

Page kidney: A rare cause of secondary hypertension

Ilonka Warnich, Mark Nicolaou, Zelia Sofianos, Jacobus A. Pienaar, Jacob Varghese
South African Journal of Radiology | Vol 23, No 1 | a1762 | DOI: https://doi.org/10.4102/sajr.v23i1.1762 | © 2019 Ilonka Warnich, Mark Nicolaou, Zelia Sofianos, Jacobus A. Pienaar, Jacob Varghese | This work is licensed under CC Attribution 4.0
Submitted: 31 May 2019 | Published: 23 September 2019

About the author(s)

Ilonka Warnich, Department of Diagnostic Radiology, University of the Witwatersrand, Johannesburg, South Africa
Mark Nicolaou, Department of Diagnostic Radiology, University of the Witwatersrand, Johannesburg, South Africa
Zelia Sofianos, Department of Diagnostic Radiology, Klerksdorp/Tshepong Hospital Complex, Klerksdorp, South Africa
Jacobus A. Pienaar, Department of Diagnostic Radiology, Klerksdorp/Tshepong Hospital Complex, Klerksdorp, South Africa
Jacob Varghese, Department of Diagnostic Radiology, Klerksdorp/Tshepong Hospital Complex, Klerksdorp, South Africa

Abstract

Page kidney is a rare phenomenon that can present with hypertension. The presence of a subcapsular perirenal collection causes parenchymal compression leading to renal hypoperfusion. Subsequent activation of the renin–angiotensin–aldosterone system results in an increase in systemic blood pressure. The causes of renal subcapsular collections are varied, with most cases being secondary to post-traumatic haematomas. We present the case of a young hypertensive patient, treated as primary hypertension with persistently uncontrolled blood pressures. This was despite good treatment adherence. On further investigation, imaging identified the presence of bilateral subcapsular collections. This case illustrates the importance of a thorough workup in a young hypertensive patient with refractory hypertension. Given that Page kidney is curable, timeous intervention can save the patient from unnecessary medications and the morbidity of uncontrolled blood pressures.

Keywords

Page kidney; young; hypertension; secondary hypertension; subcapsular collection.

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