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Case Reports: Unusual association of diseases/symptoms
Inferior vena cava and renal vein thrombosis: a rare cause of acute kidney injury in tuberculosis
  1. Aishwarya Veeresh Anweri,
  2. Shivashankara Kaniyoor Nagri and
  3. Shubhada Karanth
  1. Department of General Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
  1. Correspondence to Dr Shubhada Karanth; shubhada.u{at}manipal.edu

Abstract

Recent studies show active tuberculosis induces a prothrombotic state and increases the risk of venous thromboembolism. We report a recently diagnosed case of tuberculosis who presented to our hospital with painful bilateral lower limb swelling and several episodes of vomiting with abdominal pain for 2 weeks. Investigations by a hospital elsewhere 2 weeks ago showed abnormal renal function, misdiagnosed as antitubercular therapy-induced acute kidney injury. D-dimer levels were increased on admission with us, with still deranged renal function. Imaging revealed thrombus at the origin of left renal vein, inferior vena cava and bilateral lower limbs. We started treatment with anticoagulants, which gradually improved kidney function. This case highlights that early diagnosis of renal vein thrombosis and prompt treatment are associated with good clinical outcomes. It also highlights the importance of further studies for risk assessment, prevention strategies and reduction of the burden of venous thromboembolism in patients with tuberculosis.

  • TB and other respiratory infections
  • Acute renal failure
  • Tuberculosis

http://dx.doi.org/10.1136/bcr-2022-254084

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    Footnotes

    • Contributors AVA performed a literature search and wrote the article. SKN identified and managed the case, had the idea for the article and critically revised the article. SK managed the case, critically revised the article and is the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.