EXTENDED DEEP-VEIN AND INFERIOR VENA-CAVA THROMBOSIS IN A 15-YEAR-OLDBOY - SUCCESSFUL LYSIS WITH RECOMBINANT TISSUE-TYPE PLASMINOGEN-ACTIVATOR 2 WEEKS AFTER ONSET OF SYMPTOMS

We present the case of a 15-year-old boy with thrombosis of the inferi or vena cava, the femoral, inguinal, and renal veins of unknown origin . Although the thrombosis was 2 weeks old, thrombolytic therapy with r ecombinant tissue-type plasminogen activator (maximum dosage: 0.4 mg/k g/h) was started as this appeared to be the only change to re-establis h normal kidney function. After 1 week, treatment was discontinued bec ause of generalized bleeding. At this time, the infrarenal inferior ve na cava was again patent with complete lysis of all other clots. Phleb ography 3 months after lysis documented an abnormal renal vein, a tubu lar, subhepatical stenosis of the inferior vena cava and a large colla teral vessel between the inferior vena cava and the azygos vein.