Idiopathic Renal Infarction: Suspicion is the Key

Renal infarction is relatively a rare condition that is often linked to the presence of underlying cardiac disease such as atrial fi brillation and valvular heart disease. While the classic presentation of renal infarction includes persistent abdominal or loin pain with high serum levels of lactate dehydrogenase (LDH), microscopic hematuria and high C-reactive protein (CRP), patients can present without these features. It is important to have high index of suspicion for this condition in patients who present with unexplained back or abdominal pain, even if there are no known traditional risk factors. Herein, we describe the case of a 42-year-old man who presented with abdominal pain and found to have acute right and subacute bilateral renal infarcts. No cause was identifi ed despite exhaustive work up. Interestingly, his urinalysis, LDH and CRP were within normal limits.