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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

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Aortic Thrombus with Bilateral Renal Infarcts: A Case Report.

¹Kern Medical, Department of Emergency Medicine, Bakersfield, California.

Clinical Practice and Cases in Emergency Medicine

|March 28, 2024

Summary

This case highlights a rare instance of bilateral renal infarction in a patient with protein C deficiency. Prompt imaging is crucial for high-risk patients presenting with symptoms suggestive of arterial thrombi.

Area of Science:

Nephrology
Hematology
Emergency Medicine

Background:

Hypercoagulable states increase risk for venous and arterial thrombi.
Protein C and S deficiencies are linked to venous thrombosis; arterial involvement is less common.
Renal artery thromboembolism can cause renal infarction, with bilateral cases being rare and severe.

Purpose of the Study:

To report a rare case of simultaneous bilateral renal infarction.
To emphasize the association between protein C deficiency and arterial thrombosis.
To highlight the importance of prompt diagnosis in at-risk patients.

Main Methods:

Case report of a 48-year-old male with known protein C deficiency.
Presentation with sudden abdominal pain.

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Diagnostic imaging via computed tomography angiogram of the abdomen.

Main Results:

Computed tomography angiogram revealed bilateral renal infarctions.
Patient experienced severe abdominal pain and developed acute kidney injury.
Conservative management was initiated; dialysis was not required.

Conclusions:

This is the first reported case of bilateral renal infarction secondary to protein C and S deficiency in emergency medicine literature.
Early and definitive imaging is essential for patients at high risk for arterial thrombi presenting with suggestive symptoms.
This case underscores the potential for severe arterial complications in protein C deficiency.