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KMID : 0359920100290050617
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Korean Journal of Nephrology
2010 Volume.29 No. 5 p.617 ~ p.622
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A Case of Acute Bilateral Renal Infarction Associated with Protein S Deficiency
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Kim Tae-Won
Kang Gun-Woo
Hong Hyo-Lim
Mun Sung-Hee
Lee In-Hee
Ahn Ki-Sung
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Abstract
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Acute renal infarction usually occurs in patients with trauma, atrial fibrillation, atherosclerosis, vasculitis, and valvular heart disease. However, it may occur, though rarely, in patients with hypercoagulable states such as protein C and protein S deficiency. We report here a case of acute bilateral renal infarction associated with type II protein S deficiency without a demonstrable underlying cause. A 48-year-old male was presented to the emergency room with an abrupt, persistent pain at the left flank area. Three-dimensional abdominal computed tomography revealed wedge-shaped, well demarcated, low density lesions in both the kidneys, which were consistent with occlusions of segmental branches of both the renal arteries. Protein S activity by clot-based assay was 43% (73.7-146.3%). The patient was treated with intravenous heparin and later warfarin. He has remained symptom-free on warfarin therapy with preserved renal function during the follow-up of 5 weeks.
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KEYWORD
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Infarction, Protein S deficiency
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