1008 Bilateral Renal Vein Thrombosis in a Neonate

Abstract

A female neonate, 35 weeks of gestation of a G1P0AB0 Caucasian mother was born after an urgent caesaean section because of diminished fetal movements and fetal bradycardia.A few days postnatally, the neonate developed macroscopic hematuria, anemia and thrombocytopenia.Multiple ultrasounds were performed and showed an adrenal haemorrhage with bilateral renal vein thrombosis and associated thrombosis in the vena cava inferior.The hematuria vanished after 2 weeks and there is still a normal renal function.DMSA showed an atrophic left kidney (15%) with a compensatory enlargement of the right kidney.After 5 months a MRI angiography demonstrate a small left kidney (4,5 cm) and a right kidney with a craniocaudal measurement of 7 cm. The vessel wall of both main renal arteries is normal. A collateral venous drainage of the underpole of the right kidney exists. This image is an affirmation of a complete obstruction of both renal veins. There is a complete obstruction in the vena cava inferior just above the ostium of the right renal collateral vessel with pronounced paralumbal veins and probably a more cranial drainage via the azygos system.The child and her father have both a heterozygote mutation factor V Leiden.