Ultrasound-guided percutaneous renal biopsy-induced accessory renal artery bleeding in an amyloidosis patient

Zhang, Qing; Ji, Yongqiang; He, Tianwei; Wang, Jianping

doi:10.1186/1746-1596-7-176

Cited by 9 publications

(13 citation statements)

References 16 publications

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“…Accessory renal arteries may be injured during percutaneous renal biopsy or during other surgical procedures. Zhang Q et al [41] reported a rare case of life-threatening bleeding after percutaneous biopsy in patients with accessory renal arteries and renal amyloidosis. The presence of multiple arteries during kidney transplantation requires a longer time for surgery.…”

Section: Introductionmentioning

confidence: 99%

Concomitant multiple anomalies of renal vessels and collecting system

et al. 2020

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Although anomalies of renal vessels and collecting system are relatively frequent, their concomitant occurrence is a rare event. During dissection of a 75-year-old male formalinembalmed cadaver, we found multiple variations in the renal vessels and renal collecting system. Both kidneys were normal in size and anteriorly malrotated, with duplex collecting system and duplex ureter. One ureter drained the upper part of the kidney and the second ureter drained the lower part of the kidney. Superior and inferior collecting systems were separated by renal parenchyma. The right kidney had two renal arteries, the first renal artery (main renal artery) originating from the abdominal aorta, passing behind the inferior vena cava and entering the kidney through the superior and inferior renal hilum. The second artery was the inferior polar artery. In addition, the right kidney had two renal veins as well. Three renal tributaries emerged from the upper and lower portion of the right renal hilum, and they joined to form the main renal vein which drained into the inferior vena cava. The lower renal vein was the inferior polar vein. The left kidney had four renal arteries (two hilar arteries and two polar arteries). The main left renal vein emerged from both superior and inferior left renal hilum, passed in front of the abdominal aorta and drained into the inferior vena cava. The left kidney also had the inferior polar vein which was divided behind the aorta (retro aortic vein) into two venous trunks. These venous trunks drained separately into posteromedial aspect of the inferior vena cava. Finally, the right testicular vein was formed by two tributaries and drained into the inferior vena cava, whereas the two left testicular veins drained separately into the left main renal vein.

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Section: Introductionmentioning

confidence: 99%

Concomitant multiple anomalies of renal vessels and collecting system

et al. 2020

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“…This finding encouraged us to reevaluate the role of extra renal artery flow for the development of FSGS. Previous reports showed that extra renal artery was related to various renal diseases, such as renal artery stenosis, renovascular hypertension, renal bleeding, hydronephrosis and secondary FSGS [2]. We assume that higher blood flow, which was delivered by aberrant renal artery to the lower portion of the right kidney, could produce glomerular hypertension with resultant glomerular scaring and FSGS.…”

Section: Discussionmentioning

confidence: 82%

“…In the present case, the angiographic findings were compatible with aberrant renal artery and renal biopsy injured the artery when the biopsy was performed from the lower pole of the right kidney. It was reported that significant biopsy-induced renal artery bleeding rarely occurred because renal artery was contracted when the kidney was punctured [2]. However, because of higher perfusion pressure of aberrant renal artery, vascular constriction induced by tissue biopsy could not prevent from clinically significant bleeding from the artery.…”

Section: Discussionmentioning

confidence: 99%

“…Renal biopsy is usually necessary for definite diagnosis and proper management for the patients with FSGS. Ultrasound-guided percutaneous renal biopsy (PRB) is an important technique for making diagnosis and obtaining prognostic information for the treatment of glomerular diseases [1,2]. Although PRB has some complications mainly related to bleeding [2,3], life-threatening complications of PRB occur in only \0.1 % of cases [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Resolution of proteinuria after transarterial embolization of aberrant renal artery in a patient with focal segmental glomerulosclerosis

et al. 2014

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A 24-year-old man was admitted to our hospital for persistent proteinuria. He was born with a low birth weight but had grown up uneventful until the age of 20 when he was found to have proteinuria. Because his body mass index was 30.9 kg/m 2 at that time, he was diagnosed as obesity-related nephropathy. However, weight reduction and administration of ACE inhibitor were minimally effective for the amelioration of proteinuria. Ultrasoundguided percutaneous renal biopsy at the lower pole of right kidney was performed. As serious bleeding occurred from the right aberrant renal artery soon after biopsy, he was treated with transarterial embolization (TAE). The day after TAE, proteinuria completely disappeared. Renal biopsy showed benign nephrosclerosis with secondary focal segmental glomerulosclerosis (FSGS). Proteinuria could be induced by increased blood flow and pressure due to abnormal blood supply from aberrant renal artery. This is the first report of resolution of proteinuria after TAE of aberrant renal artery in a patient with FSGS.

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“…The spectrum of renal symptoms and signs in amyloidosis is variable such as isolated proteinuria, nephrotic syndrome, hypertension, hypotension, renal insufficiency [ 16 ]. In this case, we did not practice the renal biopsy, as it has been reported that patients of amyloidosis resulted in serious bleeding over renal biopsy centesis [ 17 ]. Moreover, examinations revealed that the patient relied on a solitary right kidney as the left one was congenital dysplasia.…”

Section: Discussionmentioning

confidence: 99%

Primary systemic amyloidosis initially presenting with digestive symptoms: a case report and review of the literature

Lin

Mao

et al. 2015

Diagn Pathol

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Primary systemic amyloidosis (PSA) is one of systemic amyloidosis, characterized by clonal plasma cell disorder. The disease is rare and with high fatality. Signs and symptoms of PSA are various and complex, which depend on the organs involved. Here we report a case in which the patient initially suffered from gastrointestinal symptoms. Gradually periorbital purpura, skin fragility, and subsequent petechiae, ecchymoses and sclerosis of the distal limbs, appeared. Biopsy of his palmar skin showed scleroderma-like changes. However, histopathology of the petechiae lesion on forehead with Crystal Violet Staining prompted deposition of amyloid; gastric mucosal biopsy with Congo Red staining was also positive, which made clear the diagnosis of PSA. Bone marrow biopsy and serum immunofixation electrophoresis (IFE) revealed plasmacytosis and M proteinemia. Other examinations were performed to assess the function of organs. PSA was challenging due to the initial atypical clinical presentation and absence of biopsy with special staining. The case demonstrates that PSA should be considered in patients with multisystemic symptoms and biopsy with Congo Red staining should be performed to exclusively diagnose amyloidosis.

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Ultrasound-guided percutaneous renal biopsy-induced accessory renal artery bleeding in an amyloidosis patient

Cited by 9 publications

References 16 publications

Concomitant multiple anomalies of renal vessels and collecting system

Concomitant multiple anomalies of renal vessels and collecting system

Resolution of proteinuria after transarterial embolization of aberrant renal artery in a patient with focal segmental glomerulosclerosis

Primary systemic amyloidosis initially presenting with digestive symptoms: a case report and review of the literature

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