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[Three patients with a kidney infarct]
G H Koek1, D E Blockmans, P Van Hootegem
1Universitaire Ziekenhuizen, Gasthuisberg, afd. Interne Geneeskunde, Leuven, België.
Insights
Kidney infarction can cause unexplained abdominal pain and elevated LDH levels, especially in patients with cardiovascular disease or Factor-V-Leiden deficiency. Early diagnosis via CT scan and arteriography, followed by anticoagulant therapy, is crucial.
Area of Science:
- Nephrology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Cardiovascular disease and Factor-V-Leiden deficiency increase risk for vascular events.
- Abdominal pain and elevated lactate dehydrogenase (LDH) are non-specific symptoms.
Observation:
- Two patients with cardiovascular disease and one with Factor-V-Leiden deficiency presented with abdominal pain and elevated LDH.
- Abdominal CT scans revealed kidney infarction in all three cases.
- Selective kidney arteriography confirmed the diagnosis in two patients.
Findings:
- Kidney infarction was diagnosed in patients with unexplained abdominal pain and elevated LDH.
- Anticoagulant therapy was initiated for treatment.
- Elevated serum creatinine was noted in some cases.
Implications:
- Kidney infarction should be considered in the differential diagnosis of unexplained abdominal pain with elevated LDH.
- Prompt diagnosis and management are essential for patients with risk factors.
- This highlights the importance of considering vascular events in abdominal pathologies.
Abstract:
Two patients, one 76-year-old-man and one 79-year-old-woman with cardiovascular disease and one 36-year-old-man with Factor-V-Leiden deficiency (activated protein C-resistance) had abdominal pain and elevation of LDH levels. With abdominal CT scan kidney infarction was diagnosed. In two cases a selective kidney arteriography was performed to confirm the diagnosis. Treatment consisted of (re)starting anticoagulant therapy. In unexplained abdominal pain with insufficiently specific results of physical examination combined with a rapid rise of the LDH and sometimes of the serum creatinine, a kidney infarction should be considered in the differential diagnosis.