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'''For patient information page, click [[{{PAGENAME}} (patient information)|here]]
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{{Fibromuscular dysplasia}}


{{SI}}
'''Fo ptient information page, click [[{{PAGENAME}} (patient information)|here]]'''
{{CMG}}; '''Associate Editor-in-Chief:''' Shantanu Sinha, MD,FACC


==Overview==
{{CMG}}; '''Associate Editor-in-Chief:''' {{M.B}}, {{MMJ}}
'''Fibromuscular dysplasia''' (FMD) is a disease that can cause [[stenosis]] of the [[renal artery stenosis|renal arteries]], [[Carotid artery |carotid arteries]], and less commonly, the arteries of the abdomen. The disease can cause [[hypertension]], [[stroke]]s, and arterial aneurysm and dissection.


In individuals with FMD, the walls of one or more arteries undergo [[dysplasia]].  Due to this abnormal cellular development, the vessels may become [[stenosis|stenosed]].  A sufficient decrease in blood flow through the artery can cause symptoms.
'''''Synonyms and keywords:''''' FMD


==Epidemiology and Demographics==
== [[Fibromuscular dysplasia overview|Overview]] ==
===Age===
Fibromuscular dysplasia tends to occur in females between 14 and 50 years of age.  However, it has been found in children under the age of 14.


===Sex===
== [[Fibromuscular dysplasia historical perspective|Historical Perspective]] ==
Fibromuscular dysplasia affects females more than males.
== [[Fibromuscular dysplasia pathophysiology|Pathophysiology]]  ==
== [[Fibromuscular dysplasia causes|Causes]] ==
== [[Fibromuscular dysplasia differential diagnosis|Differentiating Fibromuscular dysplasia from other Diseases]] ==


==Pathophysiology==
== [[Fibromuscular dysplasia epidemiology and demographics|Epidemiology and Demographics]] ==
Fibromuscular dysplasia is characterized by fibrous thickening of the [[tunica intima|intima]], [[tunica media|media]], or [[adventitia]] of the [[renal artery]]. Up to 75% of all patients with FMD will have disease in the renal arteries. The lesions cause narrowing of the artery [[lumen (anatomy)|lumen]]. The second most common artery affected is the [[carotid]] artery, which is found in the neck and supplies the brain with blood.  Less commonly, FMD affects the arteries in the abdomen (supplying the [[liver]], [[spleen]] and [[intestines]]) and extremities (legs and arms).  More than one artery may have evidence of FMD in 28% of people with this disease (Luscher, 1986). All arteries should be checked if found.
== [[Fibromuscular dysplasia risk factors|Risk Factors]] ==
== [[Fibromuscular dysplasia natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==
== Diagnosis ==


==Signs and Symptoms==
[[Fibromuscular dysplasia history and symptoms|History and Symptoms]] | [[Fibromuscular dysplasia physical examination|Physical Examination]] | [[Fibromuscular dysplasia laboratory findings|Laboratory Findings]] | [[Fibromuscular dysplasia CT|CT]] | [[Fibromuscular dysplasia MRI|MRI]] | [[Fibromuscular dysplasia arteriography|Arteriography]] | [[Fibromuscular dysplasia ultrasound|Ultrasound]] | [[Fibromuscular dysplasia other imaging findings|Other Imaging Findings]] | [[Fibromuscular dysplasia other diagnostic studies|Other Diagnostic Studies]]
As a result of renal artery stenosis, the kidney's [[afferent arteriole|afferent arteriolar]] pressure falls.  The [[renin-angiotensin system]] is activated, causing fluid retention and hypertension. Symptoms of craniocervical involvement include headaches and lightheadedness, although patients are often asymptomatic. On physical examination, one may detect neurological symptoms secondary to a stroke, a bruit over an affected artery, and diminished distal pulses.


==Angiography==
== Treatment ==
Angiography with contrast will show a characteristic "string of beads" morphology in a vessel affected by FMD.
[[Fibromuscular dysplasia management guidelines|Management Guidelines]] | [[Fibromuscular dysplasia medical therapy|Medical Therapy]] | [[Fibromuscular dysplasia surgery|Surgery]] | [[Fibromuscular dysplasia primary prevention|Primary Prevention]] | [[Fibromuscular dysplasia secondary prevention|Secondary Prevention]] | [[Fibromuscular dysplasia cost-effectiveness of therapy| Cost-Effectiveness of Therapy]] | [[Fibromuscular dysplasia future or investigational therapies|Future or Investigational Therapies]]


==Treatment==
==Case Studies==
[[ACE inhibitor]]s, and [[Angiotensin II receptor antagonist]]s are often initial treatments of fibromuscular dysplasia. Refractory cases are often treated by [http://www.cardiosource.com/ExpertOpinions/hottopics/article.asp?paperID=82/ balloon angioplasty or stenting of the renal artery]. Besides [[hypertension|high blood pressure control]], [[platelet|anti-platelet]] drugs and [[blood thinner]] drugs may be used. Bypass surgery is a considered treatment and also vein replacement.
[[Fibromuscular dysplasia case study one|Case #1]]
 
== See also ==
* [[FMDSA|Fibromuscular Dysplasia Society of America]]
 
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{{SIB}}


[[Category:Disease]]
[[Category:Kidney diseases]]
[[Category:Kidney diseases]]
[[Category:Nephrology]]
[[Category:Nephrology]]

Latest revision as of 00:48, 18 September 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in-Chief: Mohsen Basiri M.D., Mohamadmostafa Jahansouz M.D.[2]

Synonyms and keywords: FMD

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Fibromuscular dysplasia from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | CT | MRI | Arteriography | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Management Guidelines | Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

de:Fibromuskuläre Dysplasie

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