Inferior vena cava thrombosis due to acute pyelonephritis

Bassilios, Nader; Tassart, M.; Restoux, Aymeric; Bigot, Jean-Michel; Rondeau, Eric B.; Sraër, Jean-Daniel

doi:10.1093/ndt/gfg614

Cited by 18 publications

(19 citation statements)

References 8 publications

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“…It is striking that previous case reports of renal vein thrombosis secondary to acute pyelonephritis have frequently documented newly diagnosed or poorly controlled diabetes mellitus . Our patient had severe hyperglycaemia and mild HHS on a background of poorly controlled diabetes and significant obesity.…”

Section: Discussionmentioning

confidence: 53%

“…Extension of thrombosis into the inferior vena cava and pulmonary emboli have both been reported previously as complications of renal vein thrombosis . Management is by anticoagulation alongside treatment of the underlying cause.…”

Section: Discussionmentioning

confidence: 95%

“…It is likely therefore that this patient's acute severe hyperglycaemia and chronically poorly controlled diabetes were contributory factors to the development of renal vein thrombosis in the context of pyelonephritis. She also had sepsis with Gram‐negative bacteraemia, features which have been associated with renal vein thrombosis in pyelonephritis . Endotoxins released from Gram‐negative bacteria can cause disruption of the endothelial lining of blood cells predisposing to thrombosis.…”

Section: Discussionmentioning

confidence: 99%

“…Renal vein thrombosis as a complication of acute pyelonephritis is rare and poorly recognised . The literature is confined to a few case reports . Acute pyelonephritis and sepsis can cause a hypercoaguable state which may predispose to thrombosis of the renal vein .…”

Section: Introductionmentioning

confidence: 99%

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Acute pyelonephritis with renal vein and inferior vena cava thrombosis and pulmonary emboli in poorly controlled type 2 diabetes and HHS

et al. 2016

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Renal vein thrombosis is a rare complication of acute pyelonephritis. We report a case of a 56‐year‐old woman with poorly controlled type 2 diabetes mellitus who presented with acute pyelonephritis and hyperglycaemic hyperosmolar state (HHS), complicated by thrombosis of the renal vein extending into the inferior vena cava. She was managed with intravenous antibiotics, intravenous fluids and insulin and with therapeutic low molecular weight heparin, despite which she developed pulmonary emboli two days after the diagnosis of renal vein and inferior vena caval thrombosis. Following optimisation of the dalteparin dose with factor Xa monitoring and a prolonged course of antibiotics, she made a full recovery. Two months post‐treatment there was resolution of the renal vein thrombosis and pulmonary emboli with improvement of inflammation of the right kidney on repeat computer tomography scanning. This case highlights the need to recognise renal vein thrombosis and pulmonary emboli as complications of acute pyelonephritis, especially in combination with poorly controlled diabetes mellitus, which further increases the hypercoaguable state. Copyright © 2016 John Wiley & Sons.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acute pyelonephritis with renal vein and inferior vena cava thrombosis and pulmonary emboli in poorly controlled type 2 diabetes and HHS

et al. 2016

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“…In the presence of RVT and IVCT, patients should be thoroughly screened for hypercoagulable state including hyperhomocysteinemia. Bassilos et al [6] reported a case of IVCT due to acute pyelonephritis but in that case plasma homocysteine level was not assessed. MTHFR gene deficiency is the most common form of genetic hyperhomocysteinemia and results from production of a thermolabile variant of V-MTHFR with decreased activity [3].…”

Section: Discussionmentioning

confidence: 99%

Acute pyelonephritis with renal vein and inferior vena cava thrombosis in a case of hyperhomocysteinemia

et al. 2008

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Acute pyelonephritis is not considered a common cause of renal vein (RVT) and inferior vena caval thrombosis (IVCT). Apart from malignancy, RVT is not an uncommon condition amongst patients with nephrotic syndrome, most commonly seen in patients with membranous glomerulonephritis. However, RVT occurring in association to acute pyelonephritis is rare. Clinically, it is difficult to distinguish between acute pyelonephritis and RVT because both present with fever, flank pain, and hematuria. We report a case of acute pyelonephritis with RVT and IVCT with underlying hyperhomocysteinemia. The patient was treated with systemic anticoagulation, antibiotics, and B complex therapy. At 3 months follow-up, there was complete resolution of thrombus but the left kidney was nonfunctioning.

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Renovascular involvement of systemic vascular disease: a pictorial review

et al. 2022

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Like many solid organs, the kidneys are susceptible to a wide variety of systemic vascular diseases. Comprising a significant subset of these diseases are the vasculitides, broadly encompassing numerous inflammatory conditions of the blood vessels. However, many of these conditions are non-vasculitic and non-inflammatory, and differentiation of these entities is crucial to guide the initiation of proper therapy. These non-vasculitic diseases include coagulopathic conditions leading to vascular complications, hemolysis, and hematogenous processes that can affect multiple organ systems. These systemic diseases can result in both macrovascular and microvascular pathology, involving the arteries, veins, and smaller vessels, and management of these conditions can differ significantly depending upon the underlying pathophysiology. Because the clinical manifestations of these disease processes can be heterogeneous, ranging from renal dysfunction to life-threatening hemorrhage, proper recognition of these entities is essential to help guide clinicians to the correct diagnosis and prevent potentially disastrous complications. Many of these systemic vascular processes can be detected by non-invasive imaging, including computed tomography (CT) and magnetic resonance imaging (MRI), and identification of their characteristic renal manifestations by radiologists is a critical component of patient care. This review covers a variety of these diseases and their imaging manifestations, to aid in their recognition and better equip radiologists to provide vital diagnostic information that can optimize patient care. Graphical abstract

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Inferior vena cava thrombosis due to acute pyelonephritis

Cited by 18 publications

References 8 publications

Acute pyelonephritis with renal vein and inferior vena cava thrombosis and pulmonary emboli in poorly controlled type 2 diabetes and HHS

Acute pyelonephritis with renal vein and inferior vena cava thrombosis and pulmonary emboli in poorly controlled type 2 diabetes and HHS

Acute pyelonephritis with renal vein and inferior vena cava thrombosis in a case of hyperhomocysteinemia

Renovascular involvement of systemic vascular disease: a pictorial review

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