Renovascular hypertension and coronary heart disease complicating essential thrombocythemia

A 36-year-old male was evalued for treatment-resistant hypertension. A high platelet count 828. 109 l−1, led to the diagnosis of essential thrombocythemia (ET). Aorto-renal angiography revealed critical bilateral renal artery stenosis and coronary angiography showed three-vessel disease. Percutaneous transluminal renal angioplasty was only partially successful. The patient received a 12-week course of busulphan and subsequently the thrombocyte count decreased to 200. 109 l−1 Renal angiography 12 months later showed bilateral regression of the renal artery stenosis with lowering of the blood pressure to normal levels.