Primary Aortitis and Renovascular Hypertension in a 12-Year-Old Girl

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Abstract
An autopsieid case of a girl who died from unilateral renovascular hypertension due to primary aortitis involving the right renal artery orifice is discussed; the cause of primary aortitis is obscure. Ecologically, it may be significant that the patient had a primary tuberculous infec -tion in a hilar lymph node. Also, epithelioid tubercle-like lesions in the tonsils, scattered giant cells in the thymus, and fibrinoid necrosis with tuberculoid granulation tissue in the arterial wall seemed to represent an allergic manifestation. The relationship of the hypertensive manifestations in this case to those seen in the Goldblatt kidney studies is emphasized. Use of aortic angiography to establish renovascular etiology of hypertension in children is urged as an expedient to bring these patients to surgery. Unchecked blood pressure elevation was noted as the cause of extensive cerebral changes which were the ultimate cause of death in this patient.