# Aortic Thrombus with Bilateral Renal Infarcts: A Case Report

## TL;DR

A 48-year-old man with protein C deficiency developed rare bilateral kidney damage due to blood clots, highlighting the need for quick diagnosis in high-risk patients.

## Contribution

First reported case of bilateral renal infarction linked to protein C deficiency in emergency medicine literature.

## Key findings

- Bilateral renal infarction occurred in a patient with known protein C deficiency.
- Prompt imaging confirmed the diagnosis and guided conservative treatment.
- No prior reports of this condition in emergency medicine literature.

## Abstract

The presence of a hypercoagulable state predisposes to venous and arterial thrombi. While the relationship between protein C and S deficiencies with venous thrombus formation is clear, the relationship to arterial thrombi formation is less common. Thromboembolic disease of the renal arteries may result in renal infarction. The development of simultaneous bilateral renal infarction is rare and can lead to significant morbidity and mortality.

This is a case of a 48-year-old male with known protein C deficiency who presented to the emergency department with sudden onset abdominal pain. A computed tomography angiogram of the abdomen showed bilateral renal infarctions. The patient required significant analgesia and developed acute kidney injury. He was treated conservatively, and dialysis was not required.

There are no reports in the emergency medicine literature of bilateral renal infarction secondary to protein C and S deficiency. Prompt evaluation with definitive imaging is necessary for patients who are at high risk for arterial thrombi and present with symptoms suggestive of the diagnosis.