Successful treatment of acute inferior vena cava and unilateral renal vein thrombosis by local infusion of recombinant tissue plasminogen activator

被引:20
作者
Lam, KK
Lui, CC
机构
[1] Chang Gung Mem Hosp, Div Nephrol, Dept Internal Med, Kaohsiung, Taiwan
[2] Chang Gung Mem Hosp, Dept Diagnost Radiol, Kaohsiung, Taiwan
关键词
renal vein thrombosis; tissue plasminogen activator;
D O I
10.1016/S0272-6386(98)70086-1
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Renal vein thrombosis can occur as a complication of nephrotic syndrome. We present the case of a young man with nephrotic syndrome caused by minimal change disease who developed acute inferior vena cava and left renal vein thrombosis. He was treated initially with intravenous heparin. Because of the persistence of severe left flank pain and gross hematuria, local infusion of recombinant tissue plasminogen activator was tried, with resolution of thrombi and subsidence of symptoms. Functional preservation of the involved kidney is good, as indicated by Tc-99m DMSA scan (involved kidney, 47.4%; uninvolved kidney, 52.6%). Anticoagulation is usually recommended as the treatment of choice in renal Vein thrombosis. We believe that in cases with critical presentations, such as bilateral involvement, extension into inferior vena cava, acute renal failure, pulmonary embolism or severe flank pain, thrombolytic therapy should be considered as a second-line treatment if good response is not obtained with heparin. (C) 1998 by the National Kidney Foundation, Inc.
引用
收藏
页码:1075 / 1079
页数:5
相关论文
共 27 条
[1]  
ANDERSON HV, 1993, NEW ENGL J MED, V329, P703
[2]   NEPHROTIC SYNDROME, RENAL-VEIN THROMBOSIS AND RENAL-FAILURE - REPORT OF CASE WITH RECOVERY OF RENAL FUNCTION, LOSS OF PROTEINURIA AND DISSOLUTION OF THROMBUS AFTER ANTICOAGULANT THERAPY [J].
BALANIAN, MB ;
SCHNETZLER, DE ;
KALOYANIDES, GJ .
AMERICAN JOURNAL OF MEDICINE, 1973, 54 (06) :768-776
[3]   NONOPERATIVE TREATMENT OF UNILATERAL RENAL VEIN THROMBOSIS IN NEWBORN [J].
BELMAN, AB ;
SUSMANO, DF ;
BURDEN, JJ ;
KAPLAN, GW .
JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1970, 211 (07) :1165-&
[4]   LEFT RENAL-VEIN THROMBOSIS TREATED CONSERVATIVELY [J].
BERNIE, JE ;
SCHUTTE, H ;
FERNANDEZ, R ;
FRIEDEL, WE .
JOURNAL OF UROLOGY, 1972, 107 (04) :517-+
[5]   FIBRINOLYTIC THERAPY FOR RENAL-VEIN THROMBOSIS IN THE CHILD [J].
BROMBERG, WD ;
FIRLIT, CF .
JOURNAL OF UROLOGY, 1990, 143 (01) :86-88
[6]  
Cina Gregorio, 1996, Rays (Rome), V21, P397
[7]   FIBRINOLYTIC THERAPY FOR BILATERAL RENAL-VEIN THROMBOSIS [J].
CROWLEY, JP ;
MATARESE, RA ;
QUEVEDO, SF ;
GARELLA, S .
ARCHIVES OF INTERNAL MEDICINE, 1984, 144 (01) :159-160
[8]   IDIOPATHIC NEPHROTIC SYNDROME OF THE ADULT WITH ASYMPTOMATIC THROMBOSIS OF THE RENAL-VEIN [J].
FORERO, FV ;
PRUGUE, NG ;
MORALES, NR .
AMERICAN JOURNAL OF NEPHROLOGY, 1988, 8 (06) :457-462
[9]  
HAMILTON CR, 1969, JOHNS HOPKINS MED J, V124, P331
[10]  
KAUFFMANN R H, 1978, American Journal of Medicine, V65, P607, DOI 10.1016/0002-9343(78)90848-3