Fetal renal vein thrombosis, hydrops fetalis, and maternal lupus anticoagulant. A case report

Hage, Marvin L.; Liu, Rebecca; Marcheschi, David G.; Bowie, J D; Allen, Nancy B.; Macik, B. Gail

doi:10.1002/pd.1970140918

Cited by 34 publications

(12 citation statements)

References 12 publications

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“…It has been suggested that some cases diagnosed in neonates likely began in utero, based on the chronic appearance of the sonographic findings after birth. 6,7,15 Case reports of fetal renal vein thrombosis support this hypothesis, 4,5,[10][11][12][13]16,17 as do cases of fetal IVC thrombosis associated with renal vein thrombosis. [18][19][20] Many of the various case reports of fetal renal vein thrombosis were summarized in a recent review.…”

Section: Discussionmentioning

confidence: 86%

Sonographic Findings in Fetal Renal Vein Thrombosis

Gerber

Bromley

Benson

et al. 2015

J of Ultrasound Medicine

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We present the sonographic findings of fetal renal vein thrombosis in a series of 6 patients. The mean gestational age at diagnosis was 31.2 weeks. Four cases were unilateral, and 2 were bilateral. The most common findings were renal enlargement and intrarenal vascular calcifications, followed by increased renal parenchymal echogenicity. Inferior vena cava thrombosis was found in 4 patients and common iliac vein thrombosis in 2. Fetal renal vein thrombosis is an uncommon diagnosis with characteristic sonographic findings. The presence of these findings should prompt Doppler interrogation of the renal vein and inferior vena cava to confirm the diagnosis.

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Section: Discussionmentioning

confidence: 86%

Sonographic Findings in Fetal Renal Vein Thrombosis

Gerber

Bromley

Benson

et al. 2015

J of Ultrasound Medicine

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“…Only 5 cases of venous thrombosis were reported in the studies included in this review [1, 7–9, 19]. We observed 1 case of a neonate [8] who developed thrombosis in the aorta, left renal artery, middle cerebral artery, and superior sagittal sinus.…”

Section: Discussionmentioning

confidence: 98%

“…Of the 21 cases reported, 9 mothers had APS and among them, 1 developed SLE after pregnancy and another was diagnosed with APS only because of the clinical manifestations observed in her newborn [1, 2]. Despite having no history of thrombotic events, 6 other case reports demonstrated positivity of at least 1 antiphospholipid antibody; these 6 mothers were healthy, which suggests the de novo production of antiphospholipid antibodies by the neonates [7, 9–11, 13, 16–22]. Within the case reports, anti-cardiolipin antibody appeared to be the most common disease-associated antibody, and its presence was detected in 62% of the newborns.…”

Section: Discussionmentioning

confidence: 99%

Clinical, Laboratory, and Therapeutic Analyses of 21 Patients with Neonatal Thrombosis and Antiphospholipid Antibodies: A Literature Review

Peixoto

Carvalho²,

Rodrigues

2014

Journal of Immunology Research

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Objectives. A review of the literature reports neonatal thrombosis and antiphospholipid antibodies cases through a retrospective study that focuses on the pathogenesis and main clinical and laboratory manifestations of this disease. Methods. The case reports were selected from PubMed. The keywords used to search were neonatal, antiphospholipid syndrome, thrombosis, and antiphospholipid antibodies. References that were published from 1987 to 2013 were reviewed. Results. Twenty-one cases of neonatal thrombosis and antiphospholipid antibodies were identified. Ten children were born preterm (before 37 weeks). Arterial involvement (17/21) was predominant, of which stroke (12/17) was the most prevalent clinical manifestation. Anti-cardiolipin antibodies were predominant (13/21) in the antiphospholipid antibody profiles. Treatments were based on the use of symptomatics such as antiepileptics (8/21), and 6/21 patients received heparin. There were 4 deaths (4/21); otherwise, the children recovered well, especially the neonates who suffered from strokes (9/12). Conclusion. Neonatal thrombosis and antiphospholipid antibodies are rare. The development of thrombotic manifestations in neonates seems not to be associated exclusively with the aPL, but their etiology may be linked to pre- and perinatal events. We noted good therapeutic responses, especially in stroke patients, who presented with favorable outcomes in 82% of the cases.

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“…In one case, no clear causal factor was found for the fetal distress. Maternal morbidities present in the other cases were diabetes mellitus associated with pyelonephritis, gastroenteritis, preeclampsia, meconial peritonitis, gestational diabetes, disseminated lupus erythematosus, 9 and fetal hydrops due to a cytomegalovirus infection. 10 …”

Section: Discussionmentioning

confidence: 99%

Antenatal renal vein thrombosis after accidental electric shock in a pregnant woman.

Anguenot

1999

Journal of Ultrasound in Medicine

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In utero RVT is not commonly suspected in the differential diagnosis of a renal mass in the fetus. To date, only six antenatal cases have been published. While the causes are diverse and the pathophysiologic mechanisms unclear, antenatal RVT is frequently associated with fetal distress. We report a new case of antenatal RVT, revealed by ultrasonography performed at 36 weeks' gestation for fetal distress, after an accidental electric shock 2 weeks earlier. CASE REPORTA 32 year old gravida 8 para 5 woman consulted the emergency department at 34 weeks' gestation after having received an electric shock. While mowing her lawn in bare feet, she accidentally grasped a partially unprotected area of her lawn mower's electric cable sheath. According to witnesses, her right hand firmly grasped the cable, after which she fell on her knees without losing consciousness. Her history suggested vertical flow of electric current from her right hand (entry point) to her bare feet (exit point), in that electric current travels to the area of lower resistance.She reported decreased fetal movements. The results of the obstetric examination were normal. Fetal well-being appeared normal, assessed by five cardiotocograms over a 24 h period and by fetal ultrasonography, which showed no pathologic conditions as compared to her 22 weeks' ultrasonography. No burn marks were observed. Her electrocardiogram showed a sinus tachycardia. She left the department after 24 h of observation, the fetal condition and hers considered normal.Two weeks later (36 weeks' of pregnancy), the patient returned to the emergency department, reporting an absence of fetal activity for the last 48 h. She also complained of pain in the fifth digit of her right hand, which was found to be the site of a punctiform third degree burn lesion. The patient was experiencing spontaneous uterine contractions, and a cardiotocogram revealed fetal tachycardia (170 beats/min), markedly reduced beat to beat variability, absence of accelerations, and sporadic late decelerations. The placenta, amniotic fluid index, and Doppler umbilical flow were all normal on sonographic

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Fetal renal vein thrombosis, hydrops fetalis, and maternal lupus anticoagulant. A case report

Abstract: Hydrops fetalis with fetal renal vein thrombosis in a mother with antiphospholipid antibody syndrome detected post-partum suggests an underlying pathogenetic association that may provide new strategies for treatment of a lethal disorder.

Cited by 34 publications

References 12 publications

Sonographic Findings in Fetal Renal Vein Thrombosis

Sonographic Findings in Fetal Renal Vein Thrombosis

Clinical, Laboratory, and Therapeutic Analyses of 21 Patients with Neonatal Thrombosis and Antiphospholipid Antibodies: A Literature Review

Antenatal renal vein thrombosis after accidental electric shock in a pregnant woman.

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