Extended deep vein and inferior vena cava thrombosis in a 15-year-old boy: successful lysis with recombinant tissue-type plasminogen activator 2 weeks after onset of symptoms.
We present the case of a 15-year-old boy with thrombosis of the inferior vena cava, the femoral, inguinal, and renal veins of unknown origin. Although the thrombosis was 2 weeks old, thrombolytic therapy with recombinant tissue-type plasminogen activator (maximum dosage: 0.4 mg/kg/h) was started as this appeared to be the only change to re-establish normal kidney function. After 1 week, treatment was discontinued because of generalized bleeding. At this time, the infrarenal inferior vena cava was again patent with complete lysis of all other clots. Phlebography 3 months after lysis documented an abnormal renal vein, a tubular, subhepatical stenosis of the inferior vena cava and a large collateral vessel between the inferior vena cava and the azygos vein.
Rosenbaum
T
T
Department of Paediatrics, Heinrich Heine Universität, Düsseldorf, Germany.
Rammos
S
S
Kniemeyer
H W
HW
Göbel
U
U
D000293:Adolescent; D005268:Femoral Vein; D006801:Humans; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage; D012082:Renal Veins; D013927:Thrombosis / Q000188:drug therapy*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014682:Vena Cava, Inferior
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator