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Lethal Renal Venous Thrombosis Complicating Dehydration in Infancy
1From the School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia.
The American Journal of Forensic Medicine and Pathology
|October 23, 2018
Summary
A severe dehydration case in an infant led to fatal renal venous thrombosis. This rare condition, often multifactorial, requires suspicion in infants with hypernatremic dehydration and hypotension.
Area of Science:
- Pediatric Pathology
- Nephrology
- Hematology
Background:
- Infants with fever and poor fluid intake are at risk of dehydration.
- Hypernatremia is a critical indicator of dehydration severity in infants.
Observation:
- A 3-month-old infant presented with cardiac arrest, severe dehydration (sodium 158.4 mmol/L), fever, and refusal to feed.
- Autopsy revealed enlarged kidneys with bilateral intraparenchymal renal vein thrombi.
Findings:
- The infant's death was attributed to bilateral renal venous system thrombosis and hypernatremic dehydration.
- The dehydration was likely caused by increased fluid needs due to fever and insufficient oral intake.
- Microscopic examination may be necessary to detect intraparenchymal venous thromboses.
Implications:
- Lethal renal venous thrombosis is a rare but critical diagnosis in infants with hypernatremic dehydration and hypotension.
- Consider inherited prothrombotic states in cases of renal venous thrombosis.
- Hematologic evaluation of family members is recommended due to potential inherited thrombotic risks.
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