Chronic Renal Vein Thrombosis With Preserved Renal Function Due to Protein S Deficiency: A Diagnostic Challenge in a Resource-Limited Setting

Renal vein thrombosis (RVT) refers to a clinical condition in which formation of a thrombus occurs in the renal veins or their branches. Though rare, incidence of RVT is most common amongst adults with nephrotic syndrome as well as the newborn infants with either a volume contraction or an inherited thrombophilia. In this case report, we present a case of left chronic RVT with symptoms of acute pyelonephritis. On evaluation for the etiology of RVT, the patient was found to have protein S deficiency and opted for medical therapy. The patient regularly followed up as an outpatient with improvement of symptoms on medical therapy. This case highlights the implications of RVT in adulthood, emphasizing the need for early diagnosis and intervention, since late identification could result in significant morbidity. However, in cases where genetic studies are declined or not possible due to resource constraints, patients can be adequately optimized medically to improve overall quality of life and decrease morbidity and mortality associated with this untreated anomaly.