Download PDF
Am J Perinatol 2001; 18(5): 293-298
DOI: 10.1055/s-2001-16993
ORIGINAL ARTICLES

Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Combination Thrombolytic and Anticoagulant Therapy for Bilateral Renal Vein Thrombosis in a Premature Infant

Nancy Weinschenk1 , Maria Pelidis2 , John Fiascone1
  • 1Division of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children, Tufts University School of Medicine, Boston, Massachusetts
  • 2Division of Hematology and Oncology, Department of Pediatrics, Floating Hospital for Children, Tufts University School of Medicine, Boston, Massachusetts
Further Information

Publication History

Publication Date:
10 September 2001 (online)

Also available at
    Permissions and Reprints

ABSTRACT

We report a premature infant with bilateral renal vein thrombosis and renal failure at 1 month of age who underwent treatment with recombinant tissue plasminogen activator and heparin sulfate. Combination thrombolytic and anticoagulation therapy was complicated by an intraventricular and intraparenchymal cerebral hemorrhage without resolution of the renal vein thrombosis. With increasing reports of successful use of this therapy for venous thrombosis, we suggest caution and continued study of its use in the premature infant and newborn.

KEYWORD

Renal vein thrombosis - TPA - prematurity - intraventricular hemorrhage

REFERENCES

  • 1 Nowak-Gottl U, Schwabe D, Schneider W, Schlosser R, Kreuz W. Thrombolysis with recombinant tissue-type plasminogen activator in renal vein thrombosis in infancy [letter].  Lancet . 1992;  340 1105
    PubMedSearch in Google Scholar
  • 2 Dillon P W, Fox P S, Berg C J, Cardella J F, Krummel T M. Recombinant tissue plasminogen activator for neonatal and pediatric vascular thrombolytic therapy.  J Pediatr Surg . 1993;  1264-1269
    PubMedSearch in Google Scholar
  • 3 Ries M, Singer H, Hofbeck M. Thrombolysis of a modified Blalock-Taussig shunt with recombinant tissue plasminogen activator in a newborn infant with pulmonary atresia and ventricular septal defect.  Br Heart J . 1994;  72 201-202
    PubMedSearch in Google Scholar
  • 4 Zenz W, Arlt F, Sodia S, Berghold A. Intracerebral hemorrhage during fibrinolytic therapy in children: a review of the literature of the last thirty years.  Semin Thromb Hemost . 1997;  23 321-332
    Thieme ConnectPubMedSearch in Google Scholar
  • 5 Kandler C, Ries M, Rupprecht T, Ruder H, Harms D. Successful systemic low-dose lysis of a caval thrombus by rt-PA in a neonate with congenital nephrotic syndrome.  J Pediatr Hematol Oncol . 1997;  19 348-350
    CrossrefPubMedSearch in Google Scholar
  • 6 Seibold-Weiger K, Vochem M, Mackensen-Haen S, Speer C. Fatal hepatic veno-occlusive disease in a newborn infant.  Am J Perinatol . 1997;  14 107-111
    PubMedSearch in Google Scholar
  • 7 Fleming R E, Barenkamp S J, Jureidini S B. Successful treatment of a Staphylococcus endocarditis vegetation with tissue plasminogen activator.  J Pediatr . 1998;  132 535-537
    PubMedSearch in Google Scholar
  • 8 Giuffre B, Compagnoni G, Farina C, Mosca F. Successful use of tissue plasminogen activator (t-PA) in catheter-related intracardiac thrombi of two premature infants.  Acta Paediatr . 1998;  87 695-698
    CrossrefPubMedSearch in Google Scholar
  • 9 Farnoux C, Camard O, Pinquier D. Recombinant tissue-type plasminogen activator therapy of thrombosis in 16 neonates.  J Pediatr . 1998;  133 137-140
    CrossrefPubMedSearch in Google Scholar
  • 10 Chalmers E A, Gibson B ES. Thrombolytic therapy in the management of pediatric thromboembolic disease.  Br J Haematol . 1999;  104 14-21
    CrossrefPubMedSearch in Google Scholar
  • 11 Schmidt B. The etiology, diagnosis and treatment of thrombotic disorders in newborn infants: a call for international and multi-institutional studies.  Semin Perinatol . 1997;  21 86-89
    PubMedSearch in Google Scholar
  • 12 Andrew M, David M, Adams M. Venous thromboembolic events in children: first analyses of the Canadian Registry of VTE.  Blood . 1994;  83 1251-1257
    CrossrefPubMedSearch in Google Scholar
  • 13 Schmidt B, Andrew M. Neonatal thrombosis: report of a prospective Canadian and International Registry.  Pediatrics . 1995;  96 939-943
    PubMedSearch in Google Scholar
  • 14 Andrew M, Michelson A D, Bouill E, Leaken M, Massicotte M P. Guidelines for antithrombotic therapy in pediatric patients.  J Pediatr . 1998;  132 575-588
    PubMedSearch in Google Scholar
  • 15 Andrew M, Brooker L A. Hemostatic complications in renal disorders of the young.  Pediatr Nephrol . 1996;  10 88-99
    PubMedSearch in Google Scholar
  • 16 O'Neill J A. Pediatric Surgery.  5th ed. Philadelphia: Mosby 1998: 1619-1620
    Search in Google Scholar
  • 17 Manco-Johnson M J, Nuss R, Hays T, Krupski W, Druse J, Manco-Johnson M L. Combined thrombolytic and anticoagulant therapy for venous thrombosis in children.  J Pediatr . 2000;  136 446-453
    CrossrefPubMedSearch in Google Scholar
  • 18 Christensen R D. Hematologic Problems of the Neonate.  1st ed. Philadelphia: WB Saunders 1999: 239-271
    Search in Google Scholar
  • 19 Hathaway W E. Safety of heparin use in the premature infant.  J Pediatr . 1997;  131 337-338
    PubMedSearch in Google Scholar
  • 20 Streif W, Andrew M. Venous thromboembolic events in pediatric patients.  Hemato Oncol Clin North Am . 1998;  12 1283-1312
    PubMedSearch in Google Scholar