{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T09:17:15Z","timestamp":1787995035259,"version":"build-2784847793"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007109","name":"Universit\u00e0 degli Studi di Ferrara","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007109","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Isolated renal artery involvement, whether inflammatory or dissecting, is an uncommon and challenging presentation in clinical practice. Its nonspecific symptoms and overlap with non-inflammatory vasculopathies complicate the distinction between localized vasculitis and isolated renal artery dissection (IRAD), two entities requiring fundamentally different therapeutic approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report two cases of unilateral renal artery pathology initially suspected to represent vasculitis. Case 1: A 47-year-old man presented with acute flank pain. CT and MRA revealed perivascular tissue surrounding the left renal artery, a small pseudoaneurysm, and patchy hypoperfusion. Serology, inflammatory markers, and PET\/CT excluded systemic vasculitis. Corticosteroid therapy led to complete radiologic resolution, consistent with a localized idiopathic fibro-inflammatory arteritis. Case 2: A 42-year-old patient developed abrupt-onset hypertension and renal ischemia. Initial imaging suggested \u201csleeve-like\u201d arterial thickening, raising concern for vasculitis. Selective angiography subsequently confirmed spontaneous renal artery dissection with thrombotic involvement of a segmental branch. The patient was managed conservatively with antihypertensives and antiplatelet therapy, achieving clinical stability and partial perfusion recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These cases illustrate the diagnostic complexity of isolated renal artery disease. Normal or only mildly elevated inflammatory markers do not reliably exclude localized vascular inflammation. Advanced cross-sectional imaging and timely angiography are essential when diagnostic uncertainty persists. Misinterpretation may result in unnecessary immunosuppression or failure to recognize IRAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A structured, multidisciplinary evaluation integrating serologic assessment, high-resolution imaging, and close follow-up is crucial for accurate diagnosis. While isolated vasculitis may require immunosuppression, IRAD typically responds to conservative therapy, underscoring the need for individualized management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10067-026-08246-0","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T03:33:14Z","timestamp":1783913594000},"page":"5931-5940","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Localized renal artery vasculopathy: avoiding misdiagnosis between inflammatory arteritis and isolated renal artery dissection"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9449-8847","authenticated-orcid":false,"given":"Sopie","family":"Secka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Calciolari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Maranini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Massara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lo Monaco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Furicchia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zairo","family":"Ferrante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierfilippo","family":"Acciarri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio Mario","family":"Cosacco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron Thomas","family":"Fargion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Govoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"8246_CR1","first-page":"p 1","volume-title":"Rheumatology","author":"MC Hochberg","year":"2022","unstructured":"Hochberg MC (2022) Rheumatology, 8th ed. 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Written informed consent was obtained from the patients for the publication of this case report.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None.","order":2,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}}]}}