Endovascular Treatment of Renal Artery Thrombosis in Living-Donor Kidney Transplant Recipient With Severe COVID-19 Disease

Purpose: Coronavirus disease 2019 (COVID-19) patients have a higher prevalence of micro-and macrovascular thrombotic events. However, the underlying mechanism for the increased thrombotic risk is not completely understood. Solid organ transplant recipients infected with SARS-CoV-2 may have an exponential increase in thrombotic risk and the best management strategy is unknown. Case Report: A female kidney transplant recipient presented with allograft’s renal artery thrombosis after a recent COVID-19 infection. Due to the risk of kidney failure or exclusion, catheter directed thrombolysis was performed. Residual thrombus was excluded using an endoprosthesis with an excellent result. There were no adverse events and kidney function improved. Conclusion: This paper reports the endovascular treatment of renal artery thrombosis in a living-donor kidney transplant recipient with severe COVID-19 disease.

Percutaneous Intervention in Acute Renal Attack

A young patient with renal infarction presented with right lower abdominal pain due to renal artery thrombosis is a rare clinical condition that warrants epidemiologic, clinical, angiographic, and prognostic importance. The patient’s condition was acute and was featured with abdominal pain, leukocytosis, and minimal renal impairment. The case presented here enabled us to widened our vision with patients presented with abdominal pain should warrant clinical suspicion about renal infarction although this is a rare clinical entity.

Isolated renal mucormycosis presenting with bilateral renal artery thrombosis: a case report

Background Mucormycosis is a rare infection caused by the fungus belonging to the order Mucorales. Mucormycosis predominantly affects immunocompromised individuals such as people with acquired immunodeficiency syndrome, blood malignancies, organ transplant, etc. Involvement of the kidneys usually occurs as a result of disseminated mucormycosis. We report a very rare case of isolated renal mucormycosis in an immunocompetant individual without any prior comorbidities who had an unusual presentation of mucormycosis. Case presentation A 17-year-old male student had presented to our emergency department with complaints of bilateral loin pain and fever for 10 days. There was no urine output for 2 days. Patient was in sepsis with acute kidney injury. A Doppler ultrasound of the abdomen revealed bilateral enlarged kidneys with absent blood flow in the renal vasculature. Dialysis was done, and patient was started on intravenous antibiotics. Patient was investigated for thrombophilia, the test results of which were normal. Sickle cell test was negative. Immunodeficiency screening was negative. Contrast-enhanced computed tomography revealed bilateral enlarged kidneys with bilateral renal artery thrombosis and mild ascitis. CT-guided renal biopsy was performed in the same sitting which revealed fungal hyphae in the background of necrotic glomeruli. Patient was started on liposomal amphotericin B with renal replacement therapy. However, patient deteriorated and succumbed to sepsis on the 4th day of admission. Conclusion Isolated renal mucormycosis with bilateral renal artery thrombosis is a very rare clinical scenario with high mortality. One must have a high degree of suspicion to diagnose renal mucormycosis at an early stage.

Rare Clinical Cases of Renal Artery Thrombosis

Objective: Renal vascular thrombosis is a thrombotic blockage of the major renal arteries resulting in acute damage or chronic kidney disease. The study aims to analyze rare clinical cases of renal artery thrombosis with following renal infarction. Materials and methods: The article present a retrospective study of examination and treatment results of patients diagnosed with the renal arteries thrombosis in the urological hospital of the Irkutsk Clinical Hospital No. 1 in the period 2012-2020. Results and Discussion: During the entire observation period, there were two clinical cases of acute renal artery thrombosis. The 86-year-old woman developed thrombosis because of atrial fibrillation, which was probably the result of inadequate correction (insufficient dose of anticoagulant). Kidney infarction had complications like rapid suppuration because of chronic urinary infection and calculus of the renal pelvis. It resulted in nephrectomy with subsequent recovery. The second case was the 45-year-old man examined according to existing standards, and the diagnosed-on time in the first hours of the disease. However, complete thrombosis of the right renal artery neutralized the effectiveness of conservative therapy with warfarin. In this case, nephrosclerosis and renal failure were natural. Conclusion: Renal artery thrombosis is a rare pathology that requires special attention from the clinician due to the high risk of renal function loss. Timely diagnosis and correct treatment tactics are especially important. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.550-555

Anuria as a Chief Presentation of Takayasu Arteritis, a Case Report

Takayasu vasculitis is a rare type of large vessel vasculitis that primarily affects the aorta and its main branches; signs and symptoms are usually due to systemic inflammation or ischemia of an organ or limb, depending on the group of blood vessels involved. In addition, Takayasu arteritis is associated with increased platelet and coagulation activity, leading to a hypercoagulable state and thrombus formation. We report a case of a 47-year-old male who presented with a history of complete anuria for 3 days and was found to have progressively worsening kidney function. Renal Doppler ultrasound confirmed the presence of bilateral renal artery thrombosis, while Contrast- Enhanced Computed Tomography (CECT) of the abdomen and pelvis showed extensive abdominal aortic thrombosis with radiological findings consistent with large vessel vacuities. After catheter-directed thrombolytic therapy of the renal arteries, the patient started producing urine and his kidney function significantly improved. Later, Positron Emission Tomography scan (PET) confirmed large vessel Takayasu arteritis. Echocardiography showed no intracardiac thrombus, along with an extensive work up for thrombophilia, as autoimmune and vasculitis serology came back negative. This is an extremely rare presentation of Takayasu arteritis, with an unusual recovery of acute renal failure after delayed anuria due to bilateral renal artery thrombosis.