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
[11]   THE CLINICAL SPECTRUM OF RENAL-VEIN THROMBOSIS [J].
KEATING, MA ;
ALTHAUSEN, AF .
JOURNAL OF UROLOGY, 1985, 133 (06) :938-945
[12]   THE CLINICAL SPECTRUM OF RENAL-VEIN THROMBOSIS - ACUTE AND CHRONIC [J].
LLACH, F ;
PAPPER, S ;
MASSRY, SG .
AMERICAN JOURNAL OF MEDICINE, 1980, 69 (06) :819-827
[13]   RENAL-VEIN THROMBOSIS AND NEPHROTIC SYNDROME [J].
LLACH, F ;
KOFFLER, A ;
MASSRY, SG .
NEPHRON, 1977, 19 (02) :65-68
[14]  
LLACH F, 1993, DIS KIDNEY, P1319
[15]   DIAGNOSIS AND SUCCESSFUL TREATMENT OF POST PARTUM RENAL-VEIN THROMBOSIS [J].
LOH, CS ;
PARR, NJ ;
DESMOND, AD .
BRITISH JOURNAL OF UROLOGY, 1989, 64 (06) :653-654
[16]   THROMBOLYTIC THERAPY - CURRENT STATUS .2. [J].
MARDER, VJ ;
SHERRY, S .
NEW ENGLAND JOURNAL OF MEDICINE, 1988, 318 (24) :1585-1595
[17]   THROMBOLYTIC THERAPY - CURRENT STATUS .1. [J].
MARDER, VJ ;
SHERRY, S .
NEW ENGLAND JOURNAL OF MEDICINE, 1988, 318 (23) :1512-1520
[18]   RENAL-VEIN THROMBOSIS TREATED WITH THROMBOLYTIC THERAPY - CASE-REPORT AND BRIEF REVIEW [J].
MARKOWITZ, GS ;
BRIGNOL, F ;
BURNS, ER ;
KOENIGSBERG, M ;
FOLKERT, VW .
AMERICAN JOURNAL OF KIDNEY DISEASES, 1995, 25 (05) :801-806
[19]   NEPHROTIC SYNDROME - VASOCONSTRICTION AND HYPERVOLEMIC TYPES INDICATED BY RENIN-SODIUM PROFILING [J].
MELTZER, JI ;
KEIM, HJ ;
LARAGH, JH ;
SEALEY, JE ;
JAN, KM ;
CHIEN, S .
ANNALS OF INTERNAL MEDICINE, 1979, 91 (05) :688-696
[20]   CONSERVATIVE MANAGEMENT OF RENAL-VEIN THROMBOSIS [J].
MILLER, RA ;
TREMANN, JA ;
ANSELL, JS .
JOURNAL OF UROLOGY, 1974, 111 (05) :568-571