Карточка-задание по английскому языку на тему «MEDICAL WRITING: CASE ABSTRACT_187»
«MEDICAL WRITING: CASE ABSTRACT_187»
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lipoprotein (a) and neonatal renal vein thrombosis: a case report
Renal vein thrombosis, although
rare in adults, is well recognized in neonates and is one of the most common
manifestations of neonatal thromboembolic events. The etiology of renal vein
thrombosis remains unidentified in the majority of cases. We report a case of
renal vein thrombosis in a neonate associated with elevated maternal
A full-term female infant,
appropriate for gestational age, was born via spontaneous vaginal delivery to
an 18-year-old primigravida. The infant's birth weight was 3680 g and the Apgar
scores were eight and nine at 1 and 5 minutes respectively. Evaluation of the
infant in the newborn nursery revealed a palpable mass in the right lumbar
area. Tests revealed hematuria and a high serum creatinine level of 1.5 mg/dl.
An abdominal ultrasound Doppler flow study demonstrated an enlarged right
kidney, right renal vein thrombosis, and progression of the thrombosis to the
inferior vena cava. There was no evidence of saggital sinus thrombosis. An
extensive work-up of parents for hypercoagulable conditions was remarkable for
a higher plasma lipoprotein (a) level of 73 mg/dl and an elevated fibrinogen
level of 512 mg/dl in the mother. All paternal levels were normal. The plasma
lipoprotein (a) level in the neonate was also normal. The neonate was treated
with low molecular weight heparin (enoxaparin) at 1.5 mg/kg/day every 12 hours
for 2 months, at which time a follow-up ultrasound Doppler flow study showed resolution
of the thrombosis in both the renal vein and the inferior vena cava.
There have been no studies to date
that have explored the effect of abnormal maternal risk factors on fetal
hemostasis. A case-control study is required to investigate whether elevated
levels of maternal lipoprotein (a) may be a risk factor for neonatal thrombotic
processes. Although infants with this presentation are typically treated with
anticoagulation, there is a lack of evidence-based guidelines. Treatment modalities
vary between study and treatment centers which warrants the establishment of a
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