Acute renal artery thrombosis associated with the use of an oral contraceptive pill
Abstract
Peripheral, and even visceral, venous thromboembolism is a known complication of oral contraceptive drugs (OCPs) but arterial disease, leading to renal infarction, is rarely reported. We describe a 36-year-old female patient who presented with sudden left loin pain for 2 days. Ultrasound examination showed a wedge-shaped echogenic lesion at lateral side of the left kidney. Computed tomography with contrast showed the area to be avascular and the arteriogram showed abrupt loss of the dorsal branch of left main renal artery, which lacked any deformities, confirming diagnosis of thrombosis-in-situe. Moreover, the pelvicalyceal system did not show abnormality which ruled out ascending infection. The patient did not have a family history or laboratory evidence of hypercoagulable disorder. An OCP was the only medication she had received in the previous 3 months. The OCP was discontinued, and the patient was treated with heparin for 3 days then Abixaban for 6 months. Subsequent CT study with contrast, 3 months later, showed lateral kidney scar. On follow up; she did not have subsequent thrombotic events up to 1 year.
Keywords: Abixaban, infarction, Kidney, oral contraceptive, thrombosis.
Keywords:
Abixaban, infarction, Kidney, oral contraceptive, thrombosis., Abixaban, infarction, Kidney, oral contraceptive, thrombosis
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References
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2. Paris B, Bobrie G, Rossignol P, Rossignol P, Le Coz S, et al. Blood pressure and renal outcome in patients with kidney infarction and hypertension. J Hypertens 2006; 24:1649-1654.
3. Antopolsky M, Simanovsky N, Stalnikowicz R, Salameh S, Hiller N. Renal infarction in the ED: 10-year experience and review of the literature. Am J Emerg Med 2012; 30:1055-1060.
4. Pymar HC, Creinin MD. The risks of oral contraceptive pills. Semin Reprod Med 2001; 19:305-312.
5. Guditi S, Ram R, Vasa R, Harke M, Prayaga A, et al. Renal infarction due to oral contraceptive pills. Clin Kidney J 2012; 5:283.
6. Bhargava A, Chopra A, Bernabela L, Chopra T. Oral contraceptive causing renal artery thrombosis. BMJ case reports 2013; bcr2012008055.
7. Domanovits H, Paulis M, Nikfardjam M, et al. Acute renal infarction. Clinical characteristics of 17 patients. Medicine 1999; 78:386–394.
8. Riehl J, Schmitt H, Bongartz D, Bergmann D, Sieberth HG. Renal artery stenosis. Evaluation with colour duplex ultrasonography. Nephrol Dial Transplant 1997; 12:1608–1614.
9. Leto C. Flip-flop enhancement in renal infarction. Abdominal radiol 2019; 44:1625-1626.
10. Lengele JP, Christophe JL, Persu A. Renal infarction management towards an etiological approach? J Hypertens 2018; 36:490-492.
11. Lambrecht GL, Malbrain ML, Coremans P, Vebist L, Verhaegen H. Acute renal infarction and heavy Marjuana smoking. Nephron 1995; 70:494-496.
12. Hoefsloot W, de Vries RA, Bruijnen R, Bosch FH. Renal infarction after cocaine abuse: A case report and review. Clin Nephrol. 2009; 72:234–236.
13. Colburn S, Childers WK, Chacon A, Swailes A, Ahmad FM, Sahi R. The cost of seeking an edge: Recurrent renal infarction in setting of recreational use of anabolic steroids. Ann Med Surg (London) 2017; 14:25–28
14. Peters B, Hadimeri H, Wahlberg R, Afghahi H. Melanotan II: a possible cause of renal infarction: review of the literature and case report. CEN Case Rep 2020; 9:159–161.
15. See-Hee Y, Yong-Lim K, Sun-Hee P, Chan-Duck K, Ji-Young C, Sung-Ro Y. Renal infarction after NSAID treatment. Korean J Med 2012; 82:618-622.
16. Fraile P, Garcia-Cosmes P, Lerma JL, et al. A 48 year old male with renal infarction and thrombophilia. Nefrologia 2008; 28:463–464.
17. Post A, den Deurwaarder E, BakkerS, de Haas R, van Meurs M, et al. Kidney infarction in patients with Covid-19. AJKD 2020; 76:431-435.
18. Combined oral contraceptives, thrombophilia and the risk of venous thromboembolism: a systematic review and meta-analysis. van Vlijmen EF, Wiewel-Verschueren S, Monster TB, Meijer K. J Thromb Haemost 2016; 14:1393-1403.
19. Kemmeren JM, Tanis BC, van den Bosch MA, et al. Risk of Arterial Thrombosis in Relation to Oral Contraceptives (RATIO) study: oral contraceptives and the risk of ischemic stroke. Stroke 2002; 33:1202–1208.
20. Kwon JH, Oh BJ, Ha SO, Kim DY, Do HH. Renal complications in patients with renal infarctions: Prevalence and risk factors. Kidney Blood Press Res 2016; 41:865-872.
21. Hamilton PB, Phillips RA, Hiller A. Duration of renal ischemia required to produce uremia. Am J Physiol 1948; 152:517-522.
22. Blum U, Billmann P, Krause T, Gabelmann A, Keller E, Moser E, Langer M. Effect of local low-dose thrombolysis on clinical outcome in acute embolic renal artery occlusion. Radiology 1993; 189:549-54.
23. Piffaretti G, Riva F, Tozzi M, Lomazzi C, Rivolta N, Carrafiello G, Castelli P. Catheter-directed thrombolysis for acute renal artery thrombosis: report of 4 cases. Vasc Endovascular Surg 2008; 42:375-379.
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El-Reshaid K, Al-Bader S, Markova Z. Acute renal artery thrombosis associated with the use of an oral contraceptive pill. JDDT [Internet]. 2Jan.2021 [cited 1May2024];10(6-s):8-0. Available from: https://www.jddtonline.info/index.php/jddt/article/view/4494
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