Successful thrombolysis of neonatal bilateral renal vein thrombosis originating in the IVC

Excerpt

We describe a case of inferior vena cava thrombosis (IVC) leading to bilateral renal vein thrombosis and renal failure in a neonate, which was successfully treated by thrombolysis. A male neonate, born at term by vaginal delivery (Apgar score 9–10–10) and weighing 4210 g at birth after a normal pregnancy, presented at 9 days of age due to failure to thrive and gross haematuria. At admission the child weighed 4200 g and appeared to be dehydrated. He was anuric with a serum creatinine of 222 μmol/L (reference 14–37 μmol/L), severe metabolic acidosis and respiratory difficulties. He had a palpable abdominal mass on the left side of the abdomen. Ultrasound examination showed enlarged hyperechogenic kidneys, especially on the left side. The renal veins and IVC could not be visualised. Magnetic resonance (MR) angiography revealed thrombosis of the IVC from the bifurcation up to the hepatic veins (Fig. 1a, b) and extending into both renal veins. There was no evidence of adrenal haemorrhage.

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