Korean J Nephrol.  2010 Sep;29(5):617-622.

A Case of Acute Bilateral Renal Infarction Associated with Protein S Deficiency

• Kim TW
• Kang GW
• Hong HL
• Mun SH
• Lee IH
• Ahn KS

Abstract

Acute renal infarction usually occurs in patients with trauma, atrial fibrillation, atherosclerosis, vasculitis, and valvular heart disease. However, it may occur, though rarely, in patients with hypercoagulable states such as protein C and protein S deficiency. We report here a case of acute bilateral renal infarction associated with type II protein S deficiency without a demonstrable underlying cause. A 48-year-old male was presented to the emergency room with an abrupt, persistent pain at the left flank area. Three-dimensional abdominal computed tomography revealed wedge-shaped, well demarcated, low density lesions in both the kidneys, which were consistent with occlusions of segmental branches of both the renal arteries. Protein S activity by clot-based assay was 43% (73.7-146.3%). The patient was treated with intravenous heparin and later warfarin. He has remained symptom-free on warfarin therapy with preserved renal function during the follow-up of 5 weeks.

Keyword

Infarction; Protein S deficiency

MeSH Terms

Atherosclerosis
Atrial Fibrillation
Emergencies
Follow-Up Studies
Heart Valve Diseases
Heparin
Humans
Infarction
Kidney
Male
Middle Aged
Protein C
Protein S
Protein S Deficiency
Renal Artery
Vasculitis
Warfarin
Heparin
Protein C
Protein S
Warfarin