Acute renal vein thrombosis, oral contraceptives, and protein S deficiency: a successful catheter-directed thrombolysis.

Abstract

Acute renal vein thrombosis (RVT) is a rare but noteworthy form of venous thromboembolism. Traditional management has been systemic anticoagulation with heparin, followed by warfarin. We report a case of acute RVT with multiple pulmonary emboli that occurred in a 40-year-old woman who was taking oral contraceptives and was subsequently found to have protein S deficiency. The patient was treated with catheter-directed thrombolysis, and complete resolution of the RVT was achieved. This case suggests that oral contraceptive use in a patient with protein S deficiency may interact in a synergistic manner in the pathogenesis of thrombosis. Also, we believe that catheter-directed thrombolysis is warranted in selective cases in the absence of overriding contraindications.

• Authors: Hyung-Kee Kim, Hyang Hee Choi, Jong-Min Lee, Seung Huh
• Journal: Annals of vascular surgery (Ann Vasc Surg) 2009 Sep-Oct Vol. 23 Issue 5 Pg. 687.e1-4 ISSN: 1615-5947 [Electronic] Netherlands
• PMID: 19631501 (Publication Type: Case Reports, Journal Article)

Chemical References

• Contraceptives, Oral
• Fibrinolytic Agents
• Urokinase-Type Plasminogen Activator

Topics

• Acute Disease
• Adult
• Contraceptives, Oral (adverse effects)
• Female
• Fibrinolytic Agents (administration & dosage)
• Humans
• Infusions, Intravenous
• Phlebography (methods)
• Protein S Deficiency (blood, complications)
• Pulmonary Embolism (blood, diagnostic imaging, drug therapy, etiology)
• Renal Veins (diagnostic imaging)
• Thrombolytic Therapy
• Tomography, X-Ray Computed
• Treatment Outcome
• Urokinase-Type Plasminogen Activator (administration & dosage)
• Venous Thrombosis (blood, diagnostic imaging, drug therapy, etiology)