Evidence map›Paper›PMID 42440241›Full record

ReviewClinical rheumatology2026

Localized renal artery vasculopathy: avoiding misdiagnosis between inflammatory arteritis and isolated renal artery dissection.

Sopie Secka, Ilaria Calciolari, Beatrice Maranini, Alfonso Massara, Andrea Lo Monaco, Filippo Furicchia, Zairo Ferrante, Pierfilippo Acciarri, Alessio Mario Cosacco, Aaron Thomas Fargion and 1 more

Abstract readCase ReportsReview
In one paragraph

Review in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sopie SeckaRheumatology Unit, Azienda Ospedaliero-Universitaria Sant'Anna, University of Ferrara, Ferrara, Italy. sopie.secka@edu.unife.it.ORCID http://orcid.org/0009-0000-9449-8847
Ilaria CalciolariRheumatology Unit, Azienda Ospedaliero-Universitaria Sant'Anna, University of Ferrara, Ferrara, Italy.
Beatrice MaraniniRheumatology Unit, Azienda Ospedaliero-Universitaria Sant'Anna, University of Ferrara, Ferrara, Italy.
Alfonso MassaraRheumatology Unit, Azienda Ospedaliero-Universitaria Sant'Anna, University of Ferrara, Ferrara, Italy.
Andrea Lo MonacoRheumatology Unit, Azienda Ospedaliero-Universitaria Sant'Anna, University of Ferrara, Ferrara, Italy.
Filippo FuricchiaDepartment of Interventional and Diagnostic Radiology, Arcispedale Sant'Anna, Ferrara, Italy.
Zairo FerranteDepartment of Interventional and Diagnostic Radiology, Arcispedale Sant'Anna, Ferrara, Italy.
Pierfilippo AcciarriUnit of Vascular and Endovascular Surgery, Thoraco-Cardio-Vascular Department, University of Ferrara, Ferrara, Italy.
Alessio Mario CosaccoUnit of Vascular and Endovascular Surgery, Thoraco-Cardio-Vascular Department, University of Ferrara, Ferrara, Italy.
Aaron Thomas FargionUnit of Vascular and Endovascular Surgery, Thoraco-Cardio-Vascular Department, University of Ferrara, Ferrara, Italy.
Marcello GovoniRheumatology Unit, Azienda Ospedaliero-Universitaria Sant'Anna, University of Ferrara, Ferrara, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIsolated renal artery involvement, whether inflammatory or dissecting, is an uncommon and challenging presentation in clinical practice. Its nonspecific symptoms and overlap with non-inflammatory vasculopathies complicate the distinction between localized vasculitis and isolated renal artery dissection (IRAD), two entities requiring fundamentally different therapeutic approaches. CASE PRESENTATION: We report two cases of unilateral renal artery pathology initially suspected to represent vasculitis. Case 1: A 47-year-old man presented with acute flank pain. CT and MRA revealed perivascular tissue surrounding the left renal artery, a small pseudoaneurysm, and patchy hypoperfusion. Serology, inflammatory markers, and PET/CT excluded systemic vasculitis. Corticosteroid therapy led to complete radiologic resolution, consistent with a localized idiopathic fibro-inflammatory arteritis. Case 2: A 42-year-old patient developed abrupt-onset hypertension and renal ischemia. Initial imaging suggested "sleeve-like" arterial thickening, raising concern for vasculitis. Selective angiography subsequently confirmed spontaneous renal artery dissection with thrombotic involvement of a segmental branch. The patient was managed conservatively with antihypertensives and antiplatelet therapy, achieving clinical stability and partial perfusion recovery. DISCUSSION: These cases illustrate the diagnostic complexity of isolated renal artery disease. Normal or only mildly elevated inflammatory markers do not reliably exclude localized vascular inflammation. Advanced cross-sectional imaging and timely angiography are essential when diagnostic uncertainty persists. Misinterpretation may result in unnecessary immunosuppression or failure to recognize IRAD.

conclusionA structured, multidisciplinary evaluation integrating serologic assessment, high-resolution imaging, and close follow-up is crucial for accurate diagnosis. While isolated vasculitis may require immunosuppression, IRAD typically responds to conservative therapy, underscoring the need for individualized management.

Indexed as

Aortic DissectionArteritisRenal ArteryAdultDiagnosis, DifferentialDiagnostic ErrorsDissection, Blood VesselHumansMagnetic Resonance AngiographyMaleMiddle AgedTomography, X-Ray ComputedAngiographyInflammatory arteritisIRADRenal artery vasculopathyVasculitis

Identifiers

PMID42440241
PMCPMC13525966

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.