CASE-REPORT - ACUTE RENAL-VEIN THROMBOSIS IN PATIENTS WITH SPINAL-CORD INJURY AND SECONDARY AMYLOIDOSIS

Chronic spinal cord injury, when complicated by chronic suppurative in fections, has replaced chronic tuberculosis as a leading cause of seco ndary amyloidosis. Renal involvement with secondary amyloidosis is cha racterized by the presence of nephrotic range proteinuria and an incre ased incidence of renal vein thrombosis. Two cases of acute renal vein thrombosis associated with secondary amyloidosis in patients with spi nal cord injury are presented. In both cases, a past history of extens ive decubitus ulcerations and urinary tract infections preceded the de velopment of nephrotic range proteinuria. In case 1, nonoliguric acute renal failure occurred after the development of acute bilateral renal vein thrombosis. The patient declined dialytic therapy and expired wi th uremia. In case 2, worsening renal function and increased proteinur ia resulted after the development of acute unilateral renal vein throm bosis. These cases include the clinical and anatomic findings of acute renal vein thrombosis that occur as a complication of secondary amylo idosis. Acute renal vein thrombosis should be considered whenever an a cute change in renal function or increase in proteinuria is noted in t his setting.