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Bilateral Renal Vein Thrombosis Secondary to Membraneous Glomerulonephritis: Successful Treatment with Thrombolytic Therapy

  • Published:
Annals of Vascular Surgery

Abstract

Renal vein thrombosis (RVT) is a rare phenomenon. Bilateral RVT is even less common. RVT has been reported as idiopathic or in association with puerperium, hypercoagulable states, membraneous glomerulonephritis (MGn), renal transplantation, malignancy, and renal vein instrumentation or trauma. Due to its rarity, the literature describing RVT consists mainly of isolated case reports and there are no consistent recommendations regarding diagnosis and treatment of this vascular emergency. We present a case of bilateral RVT associated with MGn. A 45-year-old man complaining of nonspecific abdominal pain of 2 days’ duration was found to have bilateral RVT upon computed tomographic evaluation. He was successfully treated with emergent endovascular mechanical thrombectomy in conjunction with chemical thrombolysis and subsequently therapeutically anticoagulated. A renal biopsy demonstrated MGn, and the patient was placed on an appropriate medical regimen. He is well approximately 18 months later, with preserved renal function. Despite a multitude of potential causative mechanisms, all RVT patients should undergo a thorough workup for underlying hypercoagulable disorder and underlying benign or malignant renal causes. Treatment is aimed at prompt relief of venous obstruction and preservation of renal parenchymal function. Interventional radiological procedures, including thrombolysis and thrombectomy, have proven to be valuable in the treatment of RVT. Surgical options include thrombectomy and nephrectomy.

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References

  1. Mansi MK. Postpartum renal infarction secondary to spontaneous renal vein thrombosis. J Urol 2001;165:893-894

    Article  PubMed  CAS  Google Scholar 

  2. Theiss M, Wirth MP, Dolken W, et al. Spontaneous thrombosis of the renal vessels. Rare entities to be considered in differential diagnosis of patients presenting with lumbar flank pain and hematuria. Urol Int 1992;48:441-445

    Article  PubMed  CAS  Google Scholar 

  3. Berkovich GY, Ramchandani P, Preate DL Jr, et al. Renal vein thrombosis after martial arts trauma. J Trauma 2001;50:144-145

    Article  PubMed  CAS  Google Scholar 

  4. Beersiek F, Dostal G, Eigler FW, et al. Thrombectomy for acute renal-vein thrombosis. Dtsch Med Wochenschr 1978;103:1007-1011

    Article  PubMed  CAS  Google Scholar 

  5. Glassock RJ. Diagnosis and natural course of membraneous nephropathy. Semin Nephrol 2003;23:324-332

    Article  PubMed  Google Scholar 

  6. Morrissey EC, McDonald BR, Rabetoy GM. Resolution of proteinuria secondary to bilateral renal vein thrombosis after treatment with systemic thrombolytic therapy. Am J Kidney Dis 1997;29:615-619

    Article  PubMed  CAS  Google Scholar 

  7. Demarquez JL, Tavernier J, Babin JP, et al. Renal vein thrombosis in the newborn infant. Arch Fr Pediatr 1975;32:381-392

    PubMed  CAS  Google Scholar 

  8. Larcan A, Laprevote-Heully MC, Lambert H, et al. Renal vein thrombosis with acute renal insufficiency. Cure by fibrinolytics (urokinase). J Urol Nephrol (Paris) 1974;80:802-808

    CAS  Google Scholar 

  9. Haskal ZJ. Devices for the treatment of peripheral arterial occlusions. Rev Cardiovasc Med 2002;3(Suppl. 2):S45-S52

    PubMed  Google Scholar 

  10. Bick LR. Introduction to thrombosis: proficient and cost-effective approaches to thrombosis. Hematol Oncol Clin North Am 2003;17:1-8

    Article  PubMed  Google Scholar 

  11. Rosario DJ, Radley SC, Goepel JR, et al. Renal infarction following spontaneous renal vein thrombosis in the puerperium. Br J Obstet Gynaecol 1999;106:1223-1224

    PubMed  CAS  Google Scholar 

  12. Fielding GA, Masel J, Leditschke JF. Spontaneous neonatal renal vein thrombosis. Aust NZJ Surg 1986;56:485-488

    Article  CAS  Google Scholar 

  13. Belman AB. Renal vein thrombosis in infancy and childhood: a contemporary survey. Clin Pediatr (Phila.) 1976;15:1033-1044

    Article  CAS  Google Scholar 

  14. Ellis D. Recurrent renal vein thrombosis and renal failure associated with antithrombin-III deficiency. Pediatr Nephrol 1992;6:131-134

    Article  PubMed  CAS  Google Scholar 

  15. Coel MN, Talner LB. Obstructive nephrogram due to renal vein thrombosis. Radiology 1971;101:573-574

    PubMed  CAS  Google Scholar 

  16. Kawashima A, Sandler CM, Ernst RD, et al. CT evaluation of renovascular disease. Radiographics 2000;20:1321-1340

    PubMed  CAS  Google Scholar 

  17. Leiter E, Brendler H, Kohan P. Renal vein thrombosis with spontaneous return of function. J Urol 1969;101:656-660

    PubMed  CAS  Google Scholar 

  18. Hooja V, Borkar N, Khanna N, et al. Spontaneous recovery from bilateral renal vein thrombosis in an infant. Indian Pediatr 1968;5:422-424

    PubMed  CAS  Google Scholar 

  19. Huang AB, Glanz S, Hon M, et al. Renal vein thrombolysis with selective simultaneous renal artery and renal vein infusions. J Vasc Interv Radiol 1995;6:581-584

    Article  PubMed  CAS  Google Scholar 

  20. Lee G, Watson CW, Mammen KJ, et al. Successful selective thrombolysis of a spontaneous transplant renal vein thrombosis. BJU Int 1999;83:869-870

    Article  PubMed  CAS  Google Scholar 

  21. Shepard AD. Renal vein thrombosis. In: Ernst CB, Stanley JC (eds), Current Therapy in Vascular Surgery, 2nd ed. Philadelphia: B. C. Becker, 1987, pp 376-379

    Google Scholar 

  22. Melamed ML, Kim HS, Jaar BG, et al. Combined percutaneous mechanical and chemical thrombectomy for renal vein thrombosis in kidney transplant recipients. Am J Transplant 2005;5:621-626

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, St. Luke’s Hospital and Health Network, Bethlehem, PA, USA

    Natalie Weger DO, Stanislaw P. Stawicki MD, Kevin M. Hoddinott MD & John J. Lukaszczyk MD

  2. Temple University School of Medicine, Philadelphia, PA, USA

    Garrett Roll MD

  3. Department of Surgery, St. Luke’s Hospital and Health Network, 801 Ostrum Street, Bethlehem, PA, 18015, USA

    Stanislaw P. Stawicki MD

Authors
  1. Natalie Weger DO
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  2. Stanislaw P. Stawicki MD
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  3. Garrett Roll MD
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  4. Kevin M. Hoddinott MD
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  5. John J. Lukaszczyk MD
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Corresponding author

Correspondence to Stanislaw P. Stawicki MD.

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Weger, N., Stawicki, S.P., Roll, G. et al. Bilateral Renal Vein Thrombosis Secondary to Membraneous Glomerulonephritis: Successful Treatment with Thrombolytic Therapy. Ann Vasc Surg 20, 411–414 (2006). https://doi.org/10.1007/s10016-006-9029-8

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  • DOI: https://doi.org/10.1007/s10016-006-9029-8

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