KMID : 0359920120310040242
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Korean Journal of Nephrology 2012 Volume.31 No. 4 p.242 ~ p.245
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Renal artery thrombosis secondary to sepsis-induced disseminated intravascular coagulation in acute pyelonephritis
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Lee Ja-Young
Nam Hee-Chul Kim Boo-Gyoung Kim Hyun-Gyung Jung Hee-Chan Kim Ji-Hee Yang Geun-Seok Park Youn-Jeong Kim Ka-Young Yun Yu-Seon Kim Young-Ok Yu Ji-Han
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Abstract
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There are some reports of renal vein thrombosis associated with acute pyelonephritis, but a case of renal artery thrombosis in acute pyelonephritis has not been reported yet. Here we report a case of renal artery thrombosis which developed in a patient with acute pyelonephritis complicated with sepsis-induced disseminated intravascular coagulation (DIC). A 65-year-old woman with diabetes was diagnosed with acute pyelonephritis complicated with sepsis. Escherichia coli was isolated from both blood and urine cultures. When treated with antibiotics, her condition gradually improved. She suddenly complained of severe right flank pain without fever in the recovery phase. A computed tomography scan revealed right renal artery thrombosis with concomitant renal infarction. Prophylactic anticoagulation therapy was not suggested because of sustained thrombocytopenia and increased risk of bleeding. Flank pain resolved with conservative treatment and perfusion of infarcted kidney improved at the time of discharge. To our knowledge, this is the first case of renal artery thrombosis related to acute pyelonephritis with sepsis-induced DIC.
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KEYWORD
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Coagulation, Disseminated intravascular, Pyelonephritis, Renal artery, Sepsis, Thrombosis
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