Circulatory diseases of the kidneys in infancy and childhood. VII. Diffuse hemorrhagic infarction of the kidneys without vascular thrombosis.

Abstract

IN THE preceding article it was pointed out that thrombosis of the renal veins is not necessarily associated with infarction and, on the other hand, that hemorrhage into the renal parenchyma is not invariably accompanied with thrombosis. Apart from hemorrhage into the renal substance occurring as part of a generalized bleeding tendency such as characterizes leukemia, hemophilia or purpura, massive hemorrhage in the renal parenchyma is sometimes observed in the absence of visible structural changes in the veins of the kidney. Our observations suggest, however, that the mechanism in these cases bears a close relationship to that of venous thrombosis. Our case material contains two pertinent instances of massive destruction of kidney substance by hemorrhage, both occurring in young infants. In the first of these, case 34, the patient, a 3 month old girl, had died from pneumococcic meningitis after an illness of two days' duration preceded by diarrhea. The