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

Korean Journal of Nephrology 2010;29(5):617-622.

Tae Won Kim, M.D.1, Gun Woo Kang, M.D.1, Hyo Lim Hong, M.D.1, Sung Hee Mun, M.D.2, In Hee Lee, M.D.1 and Ki Sung Ahn, M.D.1

Department of Internal Medicine¹
Department of Radiology²
Catholic University of Daegu School of Medicine, Daegu, Korea

증례 : S단백 결핍에 동반된 양측성 급성 신경색 1예

김태원1, 강건우1, 홍효림1, 문성희2, 이인희1, 안기성1

대구가톨릭대학교 의과대학 내과학교실1 , 영상의학과교실2

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.

Key Words: Infarction, Protein S deficiency