Isolated renal vein and inferior vena cava thrombosis in a young man with ulcerative colitis: diagnostic challenges and lessons learned

Abstract

We present a case of a young man, known case of ulcerative colitis, who presented with acute onset right flank pain and haematuria. Blood workup showed leucocytosis and raised serum creatinine. Cross-sectional imaging revealed renal vein with inferior vena cava thrombosis. He had a normal infectious screen and lacked septic features pointing towards non-infectious pathology. The 24-hour urine examination revealed nephrotic range proteinuria. Further evaluation was inconclusive for any defined pathology. Empiric anticoagulation was started and patient responded miraculously with restoration of vascularity to the affected kidney and discharged in stable condition.