Korean J Gastroenterol.  2009 Oct;54(4):248-251. 10.4166/kjg.2009.54.4.248.

A Case of Renal Vein Thrombosis in a Patient with Ulcerative Colitis

• Yang DJ
• Park YS
• Yu YH
• Jo YJ
• Kim SH
• Jung YY
• Hwang YH
• Jun DW

• KMID: 783231
• DOI: http://doi.org/10.4166/kjg.2009.54.4.248

Abstract

Venous thrombosis and thromboembolism appear to occur more often in patient with inflammatory bowel disease (IBD). The cause of thrombotic complications in IBD is generally considered to be associated with hypercoagulable conditions. Its prevalence rate ranges from 1% to 8% in clinical studies and rises to 39% in autopsy, but the renal vein thrombosis is very rare complication in ulcerative colitis patient. A 24-year-old man presented with intermittent abdominal pain and hematochezia for 6 months and recently developed pitting edema for few weeks. He was diagnosed as severe ulcerative colitis involving whole colon combined with thrombosis in both renal veins by colonoscopy and computed tomography scan of abdomen. We used steroid for the treatment of ulcerative colitis and both intravenous lower molecular weight heparin and warfarin for renal vein thrombosis. His symptoms were improved after treatment and maintained with mesalazine and warfarin. Follow-up abdominal CT scan showed complete resolution of both renal vein thrombosis. Currently he has been followed up for 2 years with oral mesalazine.

Keyword

Ulcerative colitis; Renal vein thrombosis; Heparin

MeSH Terms

Anticoagulants/therapeutic use
Colitis, Ulcerative/complications/*diagnosis/pathology
Colonoscopy
Heparin/therapeutic use
Humans
Male
Protein S/metabolism
*Renal Veins
Tomography, X-Ray Computed
Venous Thrombosis/complications/*diagnosis/radiography
Warfarin/therapeutic use
Young Adult

Figure

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  Fig. 1. Colonoscopic finding showed diffuse edema and fine ulceration with friability from rectum to cecal base compatible with ulcerative colitis.

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  Fig. 2. Microscopic finding revealed chronic active inflammation with crypt abscess in the colon (H&E stain, ×400).

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  Fig. 3. Abdominopelvic CT showed bilateral renal vein thrombosis (white arrows), but normal blood flow in the renal parenchyma.

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  Fig. 4. Follow-up abdominopelvic CT showed complete resolution of previous bilateral renal vein thrombosis.

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