CONGENITAL ANTITHROMBINE III DEFICIENCY IN A BOY 13 YEARS OLD 178

A 13 year old child, suffering from gunshoot trauma of the right arm, developed hypertension, gross hematuria and deterioration of renal function on the 7th postoperative day. The renal scan showed a marked impairment of glomerular function of the right kidney and a moderate one of the left kidney combined with a moderate dilatation of renal collecting system. Doppler ultrasonography showed a right renal venous thrombosis. Renal angiography showed right renal venous thrombosis and a partial thrombosis of the left renal vein. The right renal artery was selectively catheterised and fibrinolytic therapy was instituted using streptokinase 20000 u/ hour with complete thrombus resolution. The left renal artery was then catheterized and the fibrinolytic therapy was repeated with partial thrombus resolution. At the same time the patient was on nadroparine 7500 u/day. Five days later renal function had completely recovered. From the investigation of the hemostasis an antithrombine III deficiency, (AT III) 58% (normal 70- 140%), type 1 was discovered. The relatives were examined and the mother was found having an AT III deficiency, without any thrombotic symptoms from the history.