Renal vein thrombosis: a 10-year review.
OBJECTIVE
Renal vein thrombosis (RVT) is a rare cause for pediatric surgical consultation. The purpose of this study is to review the Montreal experience in the 1990s with RVT.


METHODS
A retrospective chart review was conducted from 1990 through 1999.


RESULTS
Twenty-three cases were identified by Duplex ultrasound scan. Mean length of follow-up was 42 months. Eighty-three percent (83%) of cases were diagnosed within the first month of life. In utero thrombosis was suspected in 22% and was associated with caval thrombosis and factor V Leiden. Known risk factors were present in 87%. The "diagnostic triad" of flank mass, gross hematuria, and thrombocytopenia was present in only 13% at the time of diagnosis. Long-term renal function impairment was detected in 100% of those who did not receive heparin, and in 33% of those who did receive heparin. No patient required dialysis. One patient required nephrectomy for recurrent pyelonephritis.


CONCLUSIONS
RVT occurs more commonly than anticipated. Because the "classic" triad of signs usually is absent at presentation, the presence of either a flank mass, hematuria, or thrombocytopenia in a patient with risk factors should prompt investigation for RVT. Factor V Leiden is a risk factor for in utero RVT. Anticoagulation improves renal outcome. Patients with RVT require long-term follow-up.
Zigman
A
A
Département de Chirurgie, Hĵpital Sainte-Justine, and the Montreal Children's Hospital, Montreal, Quebec, Canada.
Yazbeck
S
S
Emil
S
S
Nguyen
L
L
D000293:Adolescent; D017677:Age Distribution; D000925:Anticoagulants / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D011792:Quebec / Q000453:epidemiology; D012082:Renal Veins; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
D000925:Anticoagulants