Abnormal renal parenchyma accumulation of 123I MIBG in a child with renal artery stenosis

Hypertension is rare in the pediatric population, however renal artery stenosis (RAS) is an important cause that can be difficult to diagnose. Doppler ultrasound is the first line imaging modality, with computed tomography and magnetic resonance imaging as adjunct modalities, all with variable sensitivity for RAS. The gold standard for evaluation of RAS is invasive selective catheter angiography. We present a unique multimodality case of abnormal radiotracer uptake in the renal parenchyma on 123-Iodine metaiodobenzylguanidine (123I MIBG) scan in a patient with unilateral RAS. RAS is a potential cause of a false positive MIBG scan, and proper recognition may lead to accurate diagnosis.