CASE REPORTS 179 A CASE OF MALIGNANT HYPERTENSION SECONDARY TO

THERE have been few reports of severe hypertension secondary to renal ischemia in which the ischemic kidney remained viable long enough to induce, by the elaboration of a pressor substance, generalized pathologic changes.1*2 In 1934, Goldblatt published the first account of experimentally produced hyperten-sion in dogs secondary to renal ischemia.8 Since that time, search for corrobora-tion of this phenomenon in the human has not been entirely successful. There have been occasional reports of complete renal artery occlusion with associated hypertension of equivocal magnitude and duration.4"7 In most of these cases, however, interruption of the renal blood supply was closely followed by complete infarction and early demise of the patient due to renal insufficiency. The following case report presents a series of events which appear to resemble, more closely than has been heretofore reported, the original Goldblatt experiment. CASE REPORT A 43 year old white male clerk entered the neuropsychiatric unit of the Veterans Administration Center on December 13, 1948, complaining of extreme nervousness, * Received for publication November 27, 1950