Spontaneous renal artery thrombosis causing circulatory insufficiency in a newborn– a case report

Background: Renal artery thrombosis in newborns is a severe condition with high morbidity and mortality. Although neonates harbor intrinsic and external risk factors for thrombotic events of the renal vasculature, their occurrence is rare and requires swift diagnosis and treatment in a multidisciplinary setting. Case presentation: We report a case of a 3-day old newborn, with a normal pregnancy and birth, who presented with gross hematuria, fever, and cardiac decompensation due to left renal artery thrombosis. In addition to moderate dehydration, we could not identify any clinical risk factors for renal artery thrombosis adding to this unique presentation. Rapid but controlled blood pressure treatment and percutaneous angioplasty of the left renal artery to restore patency were successful in normalizing the cardiac function and circulatory condition. However, atrophy of the left kidney was identified during follow-up, implicating life-long consequences on the health of this patient. Conclusion: Neonatal renal artery thrombosis may present as gross hematuria and hypertension in newborns, even in the absence of umbilical catheterization or thromboembolic disorders, and requires swift, multidisciplinary treatment to prevent morbidity and mortality.