Idiopathic Renal Infarction Mimicking Appendicitis

Serafino, Marco Di; Severino, Rosa; Gullotto, Chiara; Lisanti, Francesco; Scarano, Enrico

doi:10.1155/2017/8087315

Cited by 8 publications

(3 citation statements)

References 17 publications

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“…There are currently no established treatment strategies in terms of duration of treatment for idiopathic renal infarction [ 3 ]. Table 2 depicts the reports obtained by searching for “idiopathic renal infarction” in PubMed [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. Nine cases were published between 1995 and 2021.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic Idiopathic Renal Infarction Detected Incidentally on Contrast-Enhanced Computed Tomography: A Case Report

Mizusugi,

Kenzaka

2023

Medicina

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Background: Renal infarction is an extremely rare disease. Although more than 95% of cases are symptomatic, there have been no previously reported asymptomatic cases, without any abnormal blood and urine test findings. Furthermore, the efficacy of long-term treatment of idiopathic renal infarction remains unknown. Case Presentation: A 63-year-old Japanese male underwent laparoscopy; a very low anterior resection of the rectum for lower rectal cancer (stage II) four years and five months prior to diagnosis with renal infarction. During the follow-up imaging studies, asymptomatic idiopathic renal infarction was found incidentally. The blood and urine test findings were normal. Contrast-enhanced computed tomography revealed a linearly bordered area of poor contrast in the dorsal region of the right kidney; however, no renal artery lesions, thromboembolic disease, or coagulation abnormalities were observed. Initial treatment with rivaroxaban 15 mg/day resulted in the remission of the infarcted lesion. The anticoagulation therapy was terminated after about 18 months without any incidences of re-infarction or bleeding events. Conclusions: We reported a very rare case of asymptomatic idiopathic renal infarction where blood and urine tests revealed no abnormal findings, and it was diagnosed incidentally during a post-treatment follow-up examination for lower rectal cancer. Long-term anticoagulant therapy for idiopathic renal infarction should be terminated at an appropriate time, taking the risk of bleeding into account.

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Section: Discussionmentioning

confidence: 99%

Asymptomatic Idiopathic Renal Infarction Detected Incidentally on Contrast-Enhanced Computed Tomography: A Case Report

Mizusugi,

Kenzaka

2023

Medicina

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“…In this example, however, it presented with acute renal infarction in a healthy 26-year-old female. Acute renal infarctions are rare with an incidence rate of about 0.004%-0.007% [ 2 ] and normally present in adults with a history of atrial fibrillation [ 3 ]. We present a rare case of acute renal infarction in the setting of anticardiolipin antibodies.…”

Section: Introductionmentioning

confidence: 99%

Anticardiolipin Antibodies Presenting With Acute Renal Infarction in a Healthy 26-Year-Old Female

Cross¹,

Cappola²

2022

Cureus

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A 26-year-old female presented to the emergency department with right lower quadrant pain. This pain lasted a couple of days, worsened, and was associated with nausea but no vomiting. Upon presentation, physical examination showed tenderness to palpation in the right lower quadrant with bilateral purple non-blanching discolorations present on her toes and no costovertebral angle tenderness. Contrast-enhanced computed tomography (CT) showed acute right renal infarction. Thrombophilia workup was done, which showed elevated antinuclear antibodies and anticardiolipin antibodies. Elevated lactate dehydrogenase, c-reactive protein, and sedimentation rate were also found. No other inherited thrombophilia was discovered in lab work. Combined oral contraceptives were stopped, and the patient was started on enoxaparin followed by rivaroxaban upon discharge. The antiphospholipid syndrome commonly presents in young females as recurrent miscarriages, stroke, or deep venous thrombosis. Venous thrombosis is more common than arterial. Rare arterial thrombosis manifestations of this syndrome include coronary, retinal, mesenteric, and renal. This is a rare case of anticardiolipin antibodies presenting as an acute right renal infarction. This raises the question if clinicians should screen for inherited thrombophilia before prescribing oral contraceptives.

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“…Symptoms such as anorexia, fever, nausea, and vomiting due to acute appendicitis may also be observed in acute pyelonephritis. Imaging methods such as ultrasonography (USG) and computed tomography (CT) are frequently used for diagnosis in patients presenting with abdominal pain or renal colic [2,3]. The sensitivity and specificity of CT are 94% and 95%, respectively, in diagnosis of adults presenting with abdominal pain [1,2].…”

Section: Introductionmentioning

confidence: 99%

Acute appendicitis coexisting with acute pyelonephritis causing diagnostic dilemma: a case report

2021

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Background Acute appendicitis and acute pyelonephritis are the most common diseases admitted to emergency departments. Both conditions have common symptoms such as flank pain, abdominal pain, and fever. Patients’ history, physical examination, laboratory evaluation, and imaging methods are used to differentiate these two conditions. Diverticulitis, colitis, gynecological pathologies, and ureteral stones that mimic acute appendicitis should be kept in mind as differential diagnoses. Cases of pyelonephritis mimicking acute appendicitis have been reported in the literature, but there has not been a reported case in which acute appendicitis occurs during management of acute pyelonephritis. In this article, a case report which can cause such a diagnostic dilemma has been presented. Case presentation A 42-year-old female patient presented with clinical features suggestive of acute appendicitis that developed after a diagnosis of acute pyelonephritis. She underwent laparoscopic appendectomy on account of acute appendicitis during medical treatment for acute pyelonephritis. Physical examination showed only right costovertebral tenderness without any rebound tenderness at McBurney’s point at the first admission, but during treatment rebound tenderness at McBurney’s point was also detected. The Alvarado score of the patient was 5 at the first admission and 7 when acute appendicitis was diagnosed. The patient fully recovered and was discharged after both diseases were completely treated. Conclusions As seen in this case, it should be remembered that both diseases can be seen together which causes a diagnostic dilemma. If clinical or biochemical progression is detected in a patient under treatment, imaging methods should be repeated and additional ones with higher resolutions should be used.

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Idiopathic Renal Infarction Mimicking Appendicitis

Cited by 8 publications

References 17 publications

Asymptomatic Idiopathic Renal Infarction Detected Incidentally on Contrast-Enhanced Computed Tomography: A Case Report

Asymptomatic Idiopathic Renal Infarction Detected Incidentally on Contrast-Enhanced Computed Tomography: A Case Report

Anticardiolipin Antibodies Presenting With Acute Renal Infarction in a Healthy 26-Year-Old Female

Acute appendicitis coexisting with acute pyelonephritis causing diagnostic dilemma: a case report

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