Extensive ileocaval and renal vein thrombosis mimicking acute pyelonephritis

Authors

  • Saurabh D. Khiste Department of Nephrology, Manipal Hospitals Baner, Pune, Maharashtra, India
  • Ignatius Avinash Department of Nephrology, Noble Hospital, Pune, Maharashtra, India
  • Mohammed F. Khan Department of Nephrology, Manipal Hospital, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20233735

Keywords:

Catheter-directed thrombolysis, Renal vein thrombosis, Flank pain

Abstract

Renal vein thrombosis (RVT) is a rare clinical diagnosis which is the presence of thrombus in the major renal veins or its tributaries. Major causes include nephrotic syndrome, trauma, malignancy, hypercoagulable states. Presentation could be unilateral or bilateral flank pain and/or haematuria. Symptoms could be confused with nephrolithiasis. A normal ultrasonography (USG) in the initial stage could delay the diagnosis and hence propensity for dreaded complications such as loss of renal function and pulmonary embolism. Anticoagulation is the mainstay of therapy for RVT. Review of the literature reveals that thrombolytic therapy can also be used in patients with the most severe disease. Here we present a case of a young male, who initially suspected to have acute pyelonephritis, turned out to have extensive Iliocaval and unilateral RVT secondary to factor V leiden mutation who underwent catheter directed thrombolysis and mechanical thrombectomy.

References

Singhal R, Brimble KS. Thromboembolic complications in the nephrotic syndrome: pathophysiology and clinical management. Thromb Res. 2006;118(3):397-407.

Wysokinski WE, Gosk-Bierska I, Greene EL, Grill D, Wiste H, McBane RD. Clinical characteristics and long-term follow-up of patients with renal vein thrombosis. Am J Kidney Dis. 2008;51(2):224-32.

Decoster T, Schwagten V, Hendriks J, Beaucourt L. Renal colic as the first symptom of acute renal vein thrombosis, resulting in the diagnosis of nephrotic syndrome. Eur J Emerg Med. 2009;16(4):170-1.

Ricci MA, Lloyd DA. Renal Venous Thrombosis in Infants and Children. Arch Surg. 1990;125(9):1195-9.

Asghar M, Ahmed K, Shah SS, Siddique MK, Dasgupta P, Khan MS. Renal vein thrombosis. Eur J Vasc Endovasc Surg. 2007;34(2):217-23.

Haine A, Rosenov A, Mertineit N, Baumgartner I, Schindewolf M. Catheter Directed Thrombectomy Under Temporary Catheter Based Filter Protection in Renal Vein Thrombosis and Contraindication to Anticoagulation. EJVES Vasc Forum. 2020;49:16-9.

Iemsawatdikul K, Daldrup-Link HE. Renal Vein Thrombosis. Pearls and Pitfalls in Pediatric Imaging: Variants and Other Difficult Diagnoses. 2022;9781107017498:252-4.

Downloads

Published

2023-11-29

How to Cite

Khiste, S. D., Avinash, I., & Khan, M. F. (2023). Extensive ileocaval and renal vein thrombosis mimicking acute pyelonephritis. International Journal of Research in Medical Sciences, 11(12), 4566–4568. https://doi.org/10.18203/2320-6012.ijrms20233735

Issue

Section

Case Reports