Öz
We report a case of a 40-year-old male presenting with lumbar pain resembling right renal colic, who developed unilateral partial renal artery thrombosis due to hypercoagulability. As non-contrast spiral CT did not reveal any causative pathology, computed tomography with intravenous IV contrast showed partial thrombosis of right renal artery. After admission to the hospital low-molecular-weight heparin treatment was initiated. Following the recovery from polyuria caused by acute tubular necrosis, the patient underwent prothrombotic risk factor analysis which revealed the presence of lupus anticoagulant and PAI-1 4G/5G polymorphism at heterozygous state. The patient, who developed arterial thrombosis due to hypercoagulopathy, was given oral anticoagulation therapy with warfarin for thrombosis prophylaxis
Anahtar Kelimeler
hypercoagulability lupus anticoagulant PAI-1 4G/5G polymorphism renal artery thrombosis
Kaynakça
- Abramson N,Abramson S. Hypercoagulability: Clinical Assessment and treatment. Review Article. Southern Medical Journal 2001; 94:1013-20.
- Thomas DP,Roberts HR. Hypercoagulability in Venous and Arterial Thrombosis. Annals of Internal Medicine1997; 126:638-44.
- Rosendaal FR. Risk factors for venous thrombotic disease. Thromb Haemost 1999; 82:610-9.
- Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, Larsson B, Welin L, Tibblin G. Fibrinogen as a risk factor for stroke and myocardial infarction. N Engl J Med 1984; 311:501-5.
- Meade TW, Mellows S, Brozovic M, Miller GJ, Chakrabarti RR, North WR, et al. Haemostatic function and ischaemic heart disease:principal results of the Northwick Park Heart Study. Lancet 1986;2:533-7.
- Libby P, Mach F, Schönbeck U, Bourcier T, Aikawa M. Regulation of the thrombotic potential of atheroma. Thromb Haemost 1999; 82:736-41.
- Lessman RK, Johnson SF, Coburn JW, Kaufman JJ. Renal artery embolism: clinical features and long-term follow-up of 17 cases. Ann Intern Med 1978;89:477-82.
- Hamm M, Knopfl e E, Wartenberg S, Wawroschek F, Weckermann D, Harzmann R. Low dose unenhanced helical computerized tomography for the evaluation of acute fl ank pain. J Urol 2002;167:1687-91.
- Vlachoyiannopoulos PG, Routsias JG. A novel mechanism of thrombosis in antiphospholipid antibody syndrome. J Autoimmun. 2010 Jul 15. [Epub ahead of print]
- Donadini MP, Crowther M Antiphospholipid Syndrome: A Challenging Hypercoagulable State with Systemic Manifestations. Hematol Oncol Clin North Am 2010;24:669-676.
- Greaves M. Antiphospholipid antibodies and thrombosis. Lancet 1999; 353:1348-53.
- Barcellona D, Fenu L, Cauli C, Pisu G, Marongiu F. Allele 4G of gene PAI-1 associated with prothrombin mutation G20210A increases the risk for venous thrombosis. Thromb Haemost 2003;90:1061-4.
- Dawson S, Hamsten A, Wiman B, Henney A, Humphries S. Genetic variation at the plasminogen activator inhibitor-1 locus is associated with altered levels of plasma plasminogen activator inhibitor-I activity. Arterioscler Thromb 1991;11:183-90.
- Mansfi eld MW, Stickland MH, Grant PJ. Plasminogen activator inhibitor-I (PAI-1) promoter polymorphism and coronary artery disease in non- insulin-dependent diabetes. Thromb Haemost 1995;74:1032-4.
- Gohil R, Peck G, Sharma P. The genetics of venous thromboembolism. A meta-analysis involving ~120,000 cases and 180,000 controls. Thromb Haemost 2009;102:360-70.
- Cinemre H, Bilir C, Akdemir N. Isolated Renal Vein Thrombosis Associated With MTHFR-1298 and PAI-1 4G Gene Mutations. Clin Appl Thromb Hemost 2010 16:708-10
- Xu X, Li J, sheng W, Liu L. Meta-analysis of genetic studies from journals published ın China of ischemic stroke in the Han Chinese population. Cerebrovasc Dis 2008;26:48-62.
- Tassies D, Espinosa G, Munoz-Rodriguez FJ, Freire C, Cervera R, et al. The 4G/5G polymorphism of the type 1 plasminogen activator inhibitor gene and thrombosis in patients with antiphospholipid syndrome. Artritis and Rheumatism 2000; 43:2349-58.
Öz
Kliniğimize şiddetli sağ renal kolik benzeri lomber ağrı şikayeti ile başvuran, 40 yaşındaki erkek hastada hiperkoagülabilite sonucu gelişen parsiyel unilateral renal arter trombozu olgusu sunulmuştur. Kontrastsız spiral BT incelemede şiddetli kolik yan ağrısını açıklayıcı, tıkayıcı özellikte bir patoloji gözlenmeyen hastada, kontrastlı BT ile sağ renal arter parsiyel trombozu saptandı ve hasta hospitalize edilerek, düşük moleküler ağırlıklı heparin tedavisine alındı
Anahtar Kelimeler
Hiperkoagülabilite lupus antikoagülanı PAI-1 4G/5G polimorfizmi renal arter trombozu
Kaynakça
- Abramson N,Abramson S. Hypercoagulability: Clinical Assessment and treatment. Review Article. Southern Medical Journal 2001; 94:1013-20.
- Thomas DP,Roberts HR. Hypercoagulability in Venous and Arterial Thrombosis. Annals of Internal Medicine1997; 126:638-44.
- Rosendaal FR. Risk factors for venous thrombotic disease. Thromb Haemost 1999; 82:610-9.
- Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, Larsson B, Welin L, Tibblin G. Fibrinogen as a risk factor for stroke and myocardial infarction. N Engl J Med 1984; 311:501-5.
- Meade TW, Mellows S, Brozovic M, Miller GJ, Chakrabarti RR, North WR, et al. Haemostatic function and ischaemic heart disease:principal results of the Northwick Park Heart Study. Lancet 1986;2:533-7.
- Libby P, Mach F, Schönbeck U, Bourcier T, Aikawa M. Regulation of the thrombotic potential of atheroma. Thromb Haemost 1999; 82:736-41.
- Lessman RK, Johnson SF, Coburn JW, Kaufman JJ. Renal artery embolism: clinical features and long-term follow-up of 17 cases. Ann Intern Med 1978;89:477-82.
- Hamm M, Knopfl e E, Wartenberg S, Wawroschek F, Weckermann D, Harzmann R. Low dose unenhanced helical computerized tomography for the evaluation of acute fl ank pain. J Urol 2002;167:1687-91.
- Vlachoyiannopoulos PG, Routsias JG. A novel mechanism of thrombosis in antiphospholipid antibody syndrome. J Autoimmun. 2010 Jul 15. [Epub ahead of print]
- Donadini MP, Crowther M Antiphospholipid Syndrome: A Challenging Hypercoagulable State with Systemic Manifestations. Hematol Oncol Clin North Am 2010;24:669-676.
- Greaves M. Antiphospholipid antibodies and thrombosis. Lancet 1999; 353:1348-53.
- Barcellona D, Fenu L, Cauli C, Pisu G, Marongiu F. Allele 4G of gene PAI-1 associated with prothrombin mutation G20210A increases the risk for venous thrombosis. Thromb Haemost 2003;90:1061-4.
- Dawson S, Hamsten A, Wiman B, Henney A, Humphries S. Genetic variation at the plasminogen activator inhibitor-1 locus is associated with altered levels of plasma plasminogen activator inhibitor-I activity. Arterioscler Thromb 1991;11:183-90.
- Mansfi eld MW, Stickland MH, Grant PJ. Plasminogen activator inhibitor-I (PAI-1) promoter polymorphism and coronary artery disease in non- insulin-dependent diabetes. Thromb Haemost 1995;74:1032-4.
- Gohil R, Peck G, Sharma P. The genetics of venous thromboembolism. A meta-analysis involving ~120,000 cases and 180,000 controls. Thromb Haemost 2009;102:360-70.
- Cinemre H, Bilir C, Akdemir N. Isolated Renal Vein Thrombosis Associated With MTHFR-1298 and PAI-1 4G Gene Mutations. Clin Appl Thromb Hemost 2010 16:708-10
- Xu X, Li J, sheng W, Liu L. Meta-analysis of genetic studies from journals published ın China of ischemic stroke in the Han Chinese population. Cerebrovasc Dis 2008;26:48-62.
- Tassies D, Espinosa G, Munoz-Rodriguez FJ, Freire C, Cervera R, et al. The 4G/5G polymorphism of the type 1 plasminogen activator inhibitor gene and thrombosis in patients with antiphospholipid syndrome. Artritis and Rheumatism 2000; 43:2349-58.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Case Report |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Eylül 2011 |
| Yayımlandığı Sayı | Yıl 2011Sayı: 3 |