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新生儿自发性肾动脉血栓形成导致循环功能不全——一例报告

Spontaneous renal artery thrombosis causing circulatory insufficiency in a newborn- a case report.

作者信息

Marijnen Sjors P, Straver Bart, Madden Iona, Stojanovic Jelena, van der Torren Cornelis R, de Waard Marita, van der Meijs Bram B M, Westland Rik

机构信息

Department of Pediatrics, Emma Children's Hospital- Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.

Department of Pediatric Cardiology, Emma Children's Hospital- Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.

出版信息

BMC Pediatr. 2025 Jul 2;25(1):490. doi: 10.1186/s12887-025-05809-z.

Abstract

BACKGROUND

Renal artery thrombosis in newborns is a severe condition with high morbidity and mortality. Although neonates harbor intrinsic and external risk factors for thrombotic events of the renal vasculature, their occurrence is rare and requires swift diagnosis and treatment in a multidisciplinary setting.

CASE PRESENTATION

We report a case of a 3-day old newborn, with a normal pregnancy and birth, who presented with gross hematuria, fever, and cardiac decompensation due to left renal artery thrombosis. In addition to moderate dehydration, we could not identify any clinical risk factors for renal artery thrombosis adding to this unique presentation. Rapid but controlled blood pressure treatment and percutaneous angioplasty of the left renal artery to restore patency were successful in normalizing the cardiac function and circulatory condition. However, atrophy of the left kidney was identified during follow-up, implicating life-long consequences on the health of this patient.

CONCLUSION

Neonatal renal artery thrombosis may present as gross hematuria and hypertension in newborns, even in the absence of umbilical catheterization or thromboembolic disorders, and requires swift, multidisciplinary treatment to prevent morbidity and mortality.

摘要

背景

新生儿肾动脉血栓形成是一种严重疾病,发病率和死亡率很高。尽管新生儿存在肾血管血栓形成事件的内在和外在风险因素,但其发生率很低,需要在多学科环境中迅速进行诊断和治疗。

病例报告

我们报告一例3日龄新生儿病例,其妊娠和出生过程正常,因左肾动脉血栓形成出现肉眼血尿、发热和心脏代偿失调。除中度脱水外,我们未发现任何肾动脉血栓形成的临床风险因素,这增加了该病例的独特性。快速但可控的血压治疗以及左肾动脉经皮血管成形术以恢复通畅,成功使心脏功能和循环状况恢复正常。然而,随访期间发现左肾萎缩,这对该患者的健康产生了终身影响。

结论

新生儿肾动脉血栓形成在新生儿中可能表现为肉眼血尿和高血压,即使没有脐静脉插管或血栓栓塞性疾病,也需要迅速进行多学科治疗以预防发病和死亡。

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