Secondary hyperaldosteronism in a patient with polyarteritis nodosa and renal artery aneurysms.

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that affects medium- and small-sized arteries. We report the case of a 32-year-old female with PAN in which renal involvement was revealed by a secondary hyperaldosteronism. Hypokaliemia and arterial hypertension preceded rupture of renal artery aneurysm by several months. We believe that hyperreninemia resulted from diffuse renal necrotizing vasculitis with occlusive but non-stenotic lesions. Angiography or CT scan should be performed systematically in PAN to screen for aneurysms so as to be able to consider prophylactic treatment by embolization and intensification of the general treatment. Hyperaldosteronism may reveal renal involvement in PAN and warrants an angiography if it has not yet been done.