Oral contraceptive causing renal artery thrombosis

Area of Science:

• Nephrology
• Vascular Medicine
• Pharmacology

Background:

• Oral contraceptive (OC) use is associated with an increased risk of venous thromboembolism.
• Arterial thrombosis is a less common but serious complication.
• Renal infarction is a rare manifestation of arterial thrombosis.

Observation:

• A young female presented with acute left lower quadrant pain, nausea, and vomiting.
• Investigations revealed hematuria, elevated serum creatinine, and imaging findings consistent with left renal infarct.
• The patient was febrile with leukocytosis and elevated lactate dehydrogenase.

Findings:

• Diagnosis of left renal infarct was confirmed by Technetium scan.
• Renal artery duplex and MRI ruled out stenosis and atherosclerotic disease.
• Extensive thrombophilic work-up was negative, and oral contraceptive use was identified as a potential trigger.

Implications:

• This case highlights a rare instance of renal artery thrombosis leading to acute renal infarction in the context of oral contraceptive use.
• Early anticoagulation (enoxaparin and aspirin) and discontinuation of oral contraceptives led to clinical improvement.
• This case underscores the importance of considering oral contraceptives as a potential risk factor for arterial thrombosis, even in young, otherwise healthy individuals.