Abstract
Renal vein thrombosis, one of the common thrombotic complications of nephrotic syndrome or renal cell carcinoma, is reportedly a rare complication of hormonal contraception. Solitary renal vein thrombosis in the Japanese population is thought to be very rare because the incidence of venous thromboembolism is comparatively very low in Asian populations. We report a 38-year-old Japanese female with left renal vein thrombosis associated with oral contraception and concurrent smoking as the first Japanese case of solitary renal vein thrombosis associated with oral contraceptives, with a review of the literature. Seven cases were previously reported. The results revealed that all patients complained of acute onset of pain around the involved kidney without urinary symptoms or fever, and were effectively treated with anticoagulants. Other remarkable facts include that nausea and vomiting were frequently seen, and that the renal outcome was benign, despite various initial urine abnormalities. This report may alert clinicians to the importance of these risk factors as an etiology of renal vein thrombosis even in Asian populations. Clinicians should regard renal vein thrombosis as one of the differential diagnoses for acute flank pain in patients using oral contraceptives. A detailed history taking that reveals oral contraception, smoking, and other thrombophilic predispositions as well as timely computed tomographic scans would be the keys to diagnosis. Smoking cessation should be strongly recommended to oral contraceptive users, especially women over 35 years of age, regardless of dosage.
Highlights
Renal vein thrombosis (RVT) is currently considered to be a rare complication of hormonal contraception [1]
We report a 38-year-old Japanese female with left renal vein thrombosis associated with oral contraception and concurrent smoking as the first Japanese case of solitary renal vein thrombosis associated with oral contraceptives, with a review of the literature
RVT usually presents as an insidious, chronic disease in patients with nephrotic syndrome or renal cell carcinoma
Summary
Renal vein thrombosis (RVT) is currently considered to be a rare complication of hormonal contraception [1]. A 38-year-old Japanese female smoker with a previous history of OC use visited the emergency department with a chief complaint of a sudden onset of severe left flank pain. Her present history started with exacerbation of dysmenorrhea, which induced her to take loxoprofen sodium 60 mg tid for the previous 10 days. Two years prior to her emergency department visit, the patient was diagnosed with adenomyosis uteri, myoma uteri, and iron deficiency anemia due to hypermenorrhea at that time One year prior, she was prescribed YAZ, a lowdose OC, for dysmenorrhea and hypermenorrhea due to adenomyosis, but discontinued this medication 4 months before admission due to diminished symptoms, until 5 days prior to her hospital visit. The patient stopped smoking, took no OC after admission, and was in good condition during our continuous observation at the outpatient clinic
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