Hyperhomocysteinemia with Anticoagulant-related Acute Kidney Injury

Abstract

A case of 40-year-old young woman with an extensive, acute thrombosis of left distal brachial artery following an elective laparoscopic cholecystectomy was reported. The patient underwent urgent surgical intervention for brachial artery thrombosis and was started on oral anticoagulant. Within a week, the patient presented with bleeding diathesis and acute renal insufficiency with sepsis. She was found to have markedly increased serum homocysteine level. No other thrombophilic factors could be found. On investigation, a genetic defect of homocysteine metabolism was found to be the underlying cause. The patient recovered completely on treatment with pyridoxine, cyanocobalamin, and folate.