Lerich syndrome revealed by renal failure: a case report

Abstract

Lerich syndrome, also known as aorto-iliac obliteration syndrome, is a specific entity among obliterative arteriopathies of the lower limbs, is defined as thrombotic occlusion of the aorto-iliac junction. We report a case of 60-yearold patient, chronic smoker with hypertension disease. He was admitted for an assessment of renal failure, in whom the diagnosis of chronic kidney disease was confirmed. Moreover, in the presence of renal asymmetry (4,9 cm) on renal ultrasound, a CT angiography was requested, confirming the diagnosis of Lerich syndrome with renal artery stenosis. A complementary assessment, including etiological one was performed, revealing no abnormalities. Therapeutically, the patient was placed on intermittent hemodialysis and curative anticoagulation. Our case represents a rare and fortuitous discovery of Lerich syndrome.

Keywords: Lerich syndrome; aortoiliac occlusion; renal asymmetry; renal failure; severe hypertension.

Figure 1

Axial CT scan image during the arterial phase showing a defect in opacification at the infrarenal aorta (black star) as well as the ostium of the right renal artery (white arrow).

Figure 2

Sagittal (a) and coronal (b) reconstructions of the angiographic complement which showed a significant reduction in the caliber aorta with diffuse calcifications along abdominal aorta (different arrow).