Diagnosis: Renal artery dissection. Extensive renal infarct. Thrombotic microangiopathy consistent with disseminated intravascular coagulation.

            Comments: Hypertension is the major risk factor in arterial dissection. Less frequently, dissections are related to inherited or acquired connective tissue disorders causing abnormal vascular extracellular matrix, however, there are cases of unknown cause. In this particular case, a complication was an extensive renal infarct. The thrombotic microangiopathy represented by microthrombi in the glomerular capillaries most probably correspond to a disseminated intravascular coagulation (DIC) because no lesions were seen in the renal vessels. DIC seems to be a secondary phenomenon associated with the artery dissection (Yoon SH et al. Disseminated intravascular coagulation associated with aortic dissecting aneurysm. Korean J Intern Med 2004;19:134-136).