title: Acute renal infarction and cardioembolic stroke in a patient with atrial fibrillation and hyperthyroid-induced cardiomyopathy: a case report.
abstract: BACKGROUND
  Acute renal infarction is a rare entity with varied misleading manifestations resulting in diagnostic delay, misdiagnosis, and treatment leading to renal damage.
  
  
  METHODS
  We report the case of a 28-year-old Dalit Nepalese man who presented with sudden onset occipital headache and later developed severe left flank pain. He was diagnosed with posterior cerebral infarction with hemorrhagic transformation and a subsequent acute renal infarction with atrial fibrillation and hyperthyroid-induced cardiomyopathy. He was managed with oral anticoagulant and antithyroid drug.
  
  
  CONCLUSIONS
  A high index of suspicion of acute renal infarction is required in patients with risk factors of thrombosis presenting sudden onset flank pain.
authors.affiliation: Institute of Medicine, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal. samajadhikari@gmail.com.
authors.forename: Samaj
authors.initials: S
authors.lastname: Adhikari
authors.affiliation: Institute of Medicine, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal.
authors.forename: Kumar
authors.initials: K
authors.lastname: Paudel
authors.affiliation: Institute of Medicine, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal.
authors.forename: Kamal
authors.initials: K
authors.lastname: Pandit
authors.affiliation: Institute of Medicine, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal.
authors.forename: Shovit
authors.initials: S
authors.lastname: Thapa
authors.affiliation: Institute of Medicine, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal.
authors.forename: Bikram Prasad
authors.initials: BP
authors.lastname: Gajurel
authors.affiliation: Department of Medicine, Lakes Region General Healthcare, 80 Highland Street, Laconia, NH, USA.
authors.forename: Khagendra
authors.initials: K
authors.lastname: Dahal
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000792:Angiography; D000925:Anticoagulants / Q000627:therapeutic use; D013956:Antithyroid Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000188:drug therapy; D002231:Carbimazole / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology*; D004452:Echocardiography; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications* / Q000188:drug therapy; D007238:Infarction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D000925:Anticoagulants; D013956:Antithyroid Agents; D014859:Warfarin; D002231:Carbimazole
keywords: Atrial fibrillation; Cardioembolic stroke; Hyperthyroidism; Renal infarction