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Renovascular hypertension is considered to be the commonest cause of severe hypertension in children. Most of the time renal artery stenosis is idiopathic, but rarely, it can be due to underlying vasculitis. Takayasu arteritis is a rare major vessel vasculitis in children presenting with nonspecific symptoms in its acute early phase. Delayed diagnosis due to lack of specific symptoms and laboratory criteria will lead to progressive disease resulting in fibrosis, stenosis and subsequent thrombosis involving aorta and its main branches. Hyponatraemic hypertensive syndrome (HHS) is a rare condition in children that can be observed in the presence of unilateral renal ischemia secondary to excess renin secretion. Excess renin secretion causes hypertension and diuresis and natriuresis of the contralateral healthy kidney. We report an 18month old boy with HHS secondary to unilateral renal artery stenosis due to underlying Takayasu arteritis.

Hyponatraemic hypertensive syndrome due to renal ischaemia: a rare presentation of Takayasu arteritis