Unpredictable Cause of Renal Infarction in a Young Person – a Case Report

ABSTRACT
Introduction: Renal artery occlusion is a rare but life-threatening condition that can cause renal infarction and long-term functional impairment if diagnosis and treatment are delayed. It is commonly linked to systemic thromboembolic events, and in certain cases the origin of the thrombus is uncertain. This report presents a case of renal thromboembolism caused by a paradoxical embolism in a young patient. Case presentation: We report the case of a 32-yearold male patient who presented to the emergency department with severe right lumbar pain irradiating to the right thigh and abdomen. The patient had recently experienced a dislocation of the right patella, which had been immobilized without anticoagulation therapy. Clinical and imaging investigations showed almost complete occlusion of the right renal artery, thus causing infarction of two-thirds of the right kidney. A patent foramen ovale with coexisting deep vein thrombosis suggested a paradoxical embolism as the etiology. With catheterdirected thrombolysis and thrombectomy, improvement was obtained through a multidisciplinary approach to care with interventional cardiology, vascular surgery, and nephrology. Conclusion: Although uncommon, renal artery thrombosis should be considered in patients with flank pain and thromboembolic history. Long-term anticoagulation and follow-up are essential to prevent recurrence.