Renal vein thrombosis in patients with nephrotic syndrome: CT diagnosis

Two male patients, an adult and a child, with the nephrotic syndrome were recently seen with clinical manifestations of acute Renal Vein Thrombosis (RVT) and the diagnosis was confirmed by Computed Tomography (CT) findings. The adult patient had left RVT, while the child had, at the first presentation, right RVT, followed two months later by the development of a left RVT. Subsequently, twelve asymptomatic patients with nephrotic syndrome were screened for RVT. Two adult male patients were discovered to have right RVT. All the four patients with RVT had associated thrombi in the Inferior Vena Cava (IVC). CT scans showed in all, widening of the involved renal vein containing thrombus, renal enlargement and thrombus in the IVC. CT appears to offer a direct non-invasive method of visualization of the IVC and renal veins, detecting thrombus within these vessels and demonstrating the resulting renal functional and morphological consequences, making it, suitable also for screening an asymptomatic population at high risk for RVT.