Intrarenal vascular changes in patients receiving oestrogen-containing compounds--a clinical, histological and angiographic study.

Nine patients who developed reversible hypertension and/or evidence of impaired renal function whilst taking an oestrogen-progestogen-containing compound have been investigated. Serial haematological and biochemical studies have been carried out on each patient in association with selective renal angiography and renal biopsies. Abnormalities of the peripheral renal vessels have been demonstrated in all patients and a close correlation between the histological and angiographic appearances noted. The presence of microthrombi involving glomerular capillaries or intrarenal arterioles was invariably accompanied by evidence of micro-angiopathic haemolytic anaemia along with stasis of contrast medium in the intra-renal vascular circulation. Although the three different groups of patients studied tended to show their own particular intra-renal angiographic patterns, the definitive diagnosis depended on the haematological and histoligical findings. In the majority of patients, withdrawal of the oestrogen-progestogen-containing compound resulted in clinical improvement.