Answer is D (Polyarteritis nodosa)
Amongst the options provided renal artery stenosis is least likely to
be seen in association with Polyarteritis nodosa.
Atherosclerosis and Fibromuscular disease
- Renal artery stenosis is produced predominantly by
atherosclerotic occlusive disease (80% to 90% of patients) or
tibromuscular dysplasia (10-15% of patients).- CMDT'06 p 460
- he common cause of renal artery stenosis in the middle aged and
elderly is an atheromatous plaque at origin of renal artery. Harrison
- In younger women stenosis is due to intrinsic structural
abnormalities of the arterial wall caused by a heterogenous group of lesions called 'fibromuscular dysplasia'.
PAN or Takayasu arteritis ?
CMDT do not mention PAN or Takayasu arteritis as a cause for
renal artery stenosis.
However, Takayasu arteritis is certainly a more common cause of
renal artery stenosis than PAN
Causes of Renal artery stenosis :
1. Atherosclerosis
2. Fibromuscular dysplasia
3. Non specific Aorto arteritis
4. Takayasu arteritis and giant cell arteritis (Takayasu > Giant cell)
5. Antiphospholipid syndrome
6. Transplant renal artery stenosis
7. Renal artery embolism
8. Dissecting aneurysm of aorta
9. Radiation arteritis
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