title: Catheter-directed therapy for acute renal vein thrombosis in systemic lupus erythematosus: A case report.
abstract: We report our experience using catheter-directed thrombectomy/thrombolysis (CDT) to treat a patient with acute renal vein thrombosis (RVT) associated with systemic lupus erythematosus (SLE). A 34-year-old woman presented with persistent left flank pain, and a renal ultrasonography examination revealed an enlarged left kidney. Contrast-enhanced computed tomography confirmed the presence of acute left RVT. Because medical treatment failed to relieve her pain and the renal function was deteriorating, we attempted to salvage the occluded left renal vein using an endovascular approach. The pain was completely relieved after a CDT and an overnight urokinase infusion. A follow-up computed tomography examination revealed the complete resolution of the thrombus. The creatinine level returned to normal (1.7-0.4 mg/dL), along with contrast enhancement in the left kidney, and this suggested the preservation of renal function. To our knowledge, this is the first report utilizing CDT to treat SLE-associated RVT. When the renal function is deteriorating, CDT is worth considering for RVT if conventional medical treatment has failed. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan.
authors.forename: Chien-Boon
authors.initials: CB
authors.lastname: Jong
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan.
authors.forename: Wei-Yung
authors.initials: WY
authors.lastname: Lo
authors.affiliation: Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan.|College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Mu-Yang
authors.initials: MY
authors.lastname: Hsieh
mesh_terms: D000208:Acute Disease; D000328:Adult; D002406:Catheterization, Peripheral; D000072226:Computed Tomography Angiography; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D021501:Flank Pain / Q000209:etiology; D006801:Humans; D007262:Infusions, Intravenous; D007677:Kidney Function Tests; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis; D010690:Phlebography / Q000379:methods; D012082:Renal Veins / Q000000981:diagnostic imaging; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology
chemical_list: D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator
keywords: acute; angiography; catheter-directed thrombectomy/thrombolysis; peripheral/renal; renal disease; renal vein thrombosis; systemic lupus erythematosus; thrombolytic therapy