Adult Idiopathic Renal Vein Thrombosis Mimicking Acute Pyelonephritis

Adult Idiopathic Renal Vein Thrombosis Mimicking Acute Pyelonephritis

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Renal Vein Thrombosis (RVT) is a rarely encountered condition.It occurs due to a hypercoagulable state in the body, caused by nephrotic syndrome and membranous nephropathy in the adults.Mode of presentation is variable.In sukin body lotion woolworths chronic form, it may remain silent for a long time and presenting later with symptoms of pedal oedema, varicocele, proteinuria.In acute state, it manifests as flank pain, nausea or haematuria.

We present a case of 25-year-old male, with left sided flank pain, haematuria and nausea for 4 days.Ultrasound showed enlarged kidney with altered echogenecity.No calculus was 33 14.50 r24 found on x-ray.Empirical antibiotics were started considering possibility of Acute Pyelonephritis (APN).With no improvement seen after 3 days along with no growth on urine culture, CT-urography was done.

It revealed enlarged non-excreting left kidney with thrombus seen over left renal vein extending into Inferior Vena Cava (IVC).Immediate anticoagulant therapy was started.Patients recovered gradually and after 6 months, follow-up CT showed disappearance of thrombosis.Anticoagulants were withdrawn gradually.So we highlight the possibility of RVT as a differential diagnosis to APN or renal colic and its evaluation and management.