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Unusual presentation of more common disease/injury
Kidney infarction in Friedreich's ataxia with dilated cardiomyopathy
  1. Dimitrios Stergios Evangelopoulos1,
  2. Tatiana Nataly Pirvu2,
  3. Aristomenis Exadaktylos2,
  4. Sandro Kohl2
  1. 1C’ Orthopaedic Department, University of Athens, “KAT” Accident's Hospital, Athen, Greece
  2. 2University Medicine Inselspital, Bern, Switzerland
  1. Correspondence to Dr Tatiana Nataly Pirvu, sandro.kohl{at}, t_pirvu{at}


A 37-year-old man with advanced Friedreich's ataxia was referred to our emergency department with acute exacerbated abdominal pain of unclear aetiology. Laboratory tests showed slightly increased inflammatory parameters, elevated troponin and B-type natriuretic peptide, as well as minimal proteinuria. Transthoracic echocardiography revealed a pre-existing dilated cardiomyopathy. Abdominal sonography showed no pathological alterations. Owing to persistent pain under analgesia, a contrast-enhanced CT-abdomen was performed, which revealed a non-homogeneous perfusion deficit of the right kidney, although neither abdominal vascular alteration, cardiac thrombus, deep vein thrombosis nor a patent foramen ovale could be detected. Taking all clinical and radiological results into consideration, the current incident was diagnosed as a thromboembolic kidney infarction. As a consequence, lifelong oral anticoagulation was initiated.

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