Aluloska Natasha, Janchevska Snezana, Tasic Velibor
Neonatology Department, University Children Hospital, Skopje, Republic of Macedonia.
NICU, University Clinic for Gynecology and Obstetrics, Skopje, Republic of Macedonia.
Open Access Maced J Med Sci. 2018 Aug 23;6(9):1678-1681. doi: 10.3889/oamjms.2018.306. eCollection 2018 Sep 25.
Neonatal renal vein thrombosis is the most common vascular condition in the newborn kidney, which could lead to serious complication in infants.
We report a case of the unilateral renal vein and inferior vena cava thrombosis, presented with gross hematuria and thrombocytopenia in a neonate. The neonate was a macrosomic male born to a mother with hyperglycemia in pregnancy. The baby was born with perinatal asphyxia and early neonatal infection and massive hematuria. Clinical and laboratory examination showed enlarged kidney having corticomedullary differentiation diminished and azotemia. Diagnosis of renal vein thrombosis was suspected by renal ultrasound and confirmed by magnetic urography. Prothrombotic risk factors were evaluated. The child is being managed conservatively. Measures aimed at the prevention of end-stage renal disease because of its poor outcome were highlighted. Despite anticoagulant therapy, the right kidney developed areas of scarring and then atrophy.
In this work, we present a patient with multiple entities in the aetiology of non-catheter induced renal and vena cava thrombosis in a neonate. Clinicians should suspect renal vein thrombosis in neonates when presented with early postnatal gross hematuria, palpable abdominal mass and thrombopenia.
新生儿肾静脉血栓形成是新生儿肾脏最常见的血管疾病，可导致婴儿出现严重并发症。
我们报告一例新生儿单侧肾静脉及下腔静脉血栓形成，表现为肉眼血尿和血小板减少。该新生儿为巨大儿男性，其母亲孕期患有高血糖。患儿出生时伴有围产期窒息、早期新生儿感染及大量血尿。临床及实验室检查显示肾脏增大，皮质髓质分界不清及氮质血症。通过肾脏超声怀疑肾静脉血栓形成，并经磁共振尿路造影证实。评估了血栓形成的危险因素。患儿目前正在接受保守治疗。强调了针对因其不良预后而预防终末期肾病的措施。尽管进行了抗凝治疗，但右肾仍出现瘢痕形成区域，随后萎缩。
在本研究中，我们介绍了一名病因具有多种因素的新生儿非导管性肾及腔静脉血栓形成患者。当新生儿出生后早期出现肉眼血尿、可触及的腹部肿块和血小板减少时，临床医生应怀疑肾静脉血栓形成。
