Acute renal vein thrombosis, oral contraceptives, and protein S deficiency: a successful catheter-directed thrombolysis
Kim, H.-K.; Choi, H.H.; Lee, J.-M.; Huh, S.
Annals of Vascular Surgery 23(5): 687.E1
2009
ISSN/ISBN: 1615-5947 PMID: 19631501 DOI: 10.1016/j.avsg.2009.01.006Document Number: 206812
Acute renal vein thrombosis (RVT) is a rare but noteworthy form of venous thromboembolism. Traditional management has been systemic anticoagulation with heparin, followed by warfarin. We report a case of acute RVT with multiple pulmonary emboli that occurred in a 40-year-old woman who was taking oral contraceptives and was subsequently found to have protein S deficiency. The patient was treated with catheter-directed thrombolysis, and complete resolution of the RVT was achieved. This case suggests that oral contraceptive use in a patient with protein S deficiency may interact in a synergistic manner in the pathogenesis of thrombosis. Also, we believe that catheter-directed thrombolysis is warranted in selective cases in the absence of overriding contraindications.
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