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Neonatal renal vein thrombosis — RACP Paediatrics MCQ

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HardNephrologyNeonatal renal vein thrombosisRACP Paediatrics

A term neonate born to a diabetic mother with a large-for-gestational-age birth weight develops haematuria and a palpable flank mass on day 2. The neonate appears unwell with thrombocytopenia. Renal ultrasound shows an enlarged left kidney with absent venous flow and echogenic thrombus in the renal vein. What is the most likely diagnosis?

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Reveal the answer and explanation

Correct answer: E — Bilateral renal vein thrombosis

Neonatal renal vein thrombosis presents with haematuria, palpable renal mass, and thrombocytopenia. Risk factors include IDM, dehydration, polycythaemia, and prothrombotic states. Ultrasound shows an enlarged kidney with absent venous flow. Management is supportive (hydration, correction of underlying cause). Anticoagulation is controversial and reserved for bilateral or IVC extension.

Reference: RCH Melbourne – 2023 – Neonatal Thrombosis CPG; RACP Paediatric Curriculum – Nephrology/Neonatology