SAN PEDRO COLLEGE
Bachelor of Science in Medical Laboratory Science
INTERNSHIP PROGRAM
NEONATAL RENAL VEIN THROMBOSIS
A Case Study In
CLINICAL MICROSCOPY
, OBJECTIVES OF THE STUDY
This study aims to:
1. Define and discuss the terms presented in the case.
2. Develop a diagnosis based on the patient’s history and provide factual information that
would support the diagnosis.
3. Present the affected organs and the pathophysiology of the disease.
4. Present the data and laboratory findings relevant to the case.
5. Recommend interventions based on the patient’s history and laboratory results.
, CHAPTER I
INTRODUCTION TO THE CASE
Renal vein thrombosis (RVT) is a thrombotic occlusion of one or both main renal veins
that results from local and systemic hypercoagulability due to chronic kidney disease or acute
kidney injuries. Patients having thrombosis may appear to have symptoms such as vomiting,
gross hematuria, decreased urine output, nausea, and manifestation of venous
thromboembolism. Long-term functional impairments may affect the prognosis of the disease
if such symptoms and other clinical manifestations are present.
Neonatal RVT is a well-known but rare condition for which no therapeutic consensus
exists because of the absence of large prospective and randomized series in the learning
references. Although rare, it is believed to be associated with post-glomerular
hemoconcentration and may manifest as coagulopathies, nephrotic syndrome, and
hypovolemia.
Numerous risk factors of thrombosis, including thrombophilias, birth asphyxia, sepsis,
maternal diabetes, and volume contraction, have been related with nRVT. It may present with
a clinically palpable kidney enlargement associated with hematuria, proteinuria, renal failure
and oliguria, hypertension, or thrombocytopenia.
The traditional and standard diagnostic test is venography of the inferior vena cava;
this test is diagnostic and may mobilize the clot formations. Although renal venography
historically was the gold standard test to diagnose renal vein thrombosis, Doppler
ultrasonography magnetic resonance venography is being used more frequently.
Treatment options for thrombosis include anticoagulation with heparin, thrombolysis,
support of renal function, treatment of underlying disorders, and catheter-directed or surgical
thrombectomy. Its treatment minimizes risk of new thrombi, promotes recanalization of
vessels with existing clots, and improves renal function. It should be continued if a
hypercoagulability disorder is present for at least 6 to 12 months.
Neonatal RVT continues to pose significant challenges for pediatric hematologists and
nephrologists. Although anticoagulation therapy seems to improve the condition, there are
still no up-to-date evidence-based guidelines for the treatment of infants with renal vein
thrombosis.
Bachelor of Science in Medical Laboratory Science
INTERNSHIP PROGRAM
NEONATAL RENAL VEIN THROMBOSIS
A Case Study In
CLINICAL MICROSCOPY
, OBJECTIVES OF THE STUDY
This study aims to:
1. Define and discuss the terms presented in the case.
2. Develop a diagnosis based on the patient’s history and provide factual information that
would support the diagnosis.
3. Present the affected organs and the pathophysiology of the disease.
4. Present the data and laboratory findings relevant to the case.
5. Recommend interventions based on the patient’s history and laboratory results.
, CHAPTER I
INTRODUCTION TO THE CASE
Renal vein thrombosis (RVT) is a thrombotic occlusion of one or both main renal veins
that results from local and systemic hypercoagulability due to chronic kidney disease or acute
kidney injuries. Patients having thrombosis may appear to have symptoms such as vomiting,
gross hematuria, decreased urine output, nausea, and manifestation of venous
thromboembolism. Long-term functional impairments may affect the prognosis of the disease
if such symptoms and other clinical manifestations are present.
Neonatal RVT is a well-known but rare condition for which no therapeutic consensus
exists because of the absence of large prospective and randomized series in the learning
references. Although rare, it is believed to be associated with post-glomerular
hemoconcentration and may manifest as coagulopathies, nephrotic syndrome, and
hypovolemia.
Numerous risk factors of thrombosis, including thrombophilias, birth asphyxia, sepsis,
maternal diabetes, and volume contraction, have been related with nRVT. It may present with
a clinically palpable kidney enlargement associated with hematuria, proteinuria, renal failure
and oliguria, hypertension, or thrombocytopenia.
The traditional and standard diagnostic test is venography of the inferior vena cava;
this test is diagnostic and may mobilize the clot formations. Although renal venography
historically was the gold standard test to diagnose renal vein thrombosis, Doppler
ultrasonography magnetic resonance venography is being used more frequently.
Treatment options for thrombosis include anticoagulation with heparin, thrombolysis,
support of renal function, treatment of underlying disorders, and catheter-directed or surgical
thrombectomy. Its treatment minimizes risk of new thrombi, promotes recanalization of
vessels with existing clots, and improves renal function. It should be continued if a
hypercoagulability disorder is present for at least 6 to 12 months.
Neonatal RVT continues to pose significant challenges for pediatric hematologists and
nephrologists. Although anticoagulation therapy seems to improve the condition, there are
still no up-to-date evidence-based guidelines for the treatment of infants with renal vein
thrombosis.
