# Renal Infarction Following Anticoagulant Discontinuation in a Pediatric Patient With Congenital Heart Disease

## TL;DR

A child with heart disease developed kidney damage after stopping blood thinners, highlighting a possible risk for similar cases.

## Contribution

This case report identifies anticoagulant discontinuation as a potential risk factor for renal infarction in pediatric patients with congenital heart disease.

## Key findings

- A nine-year-old boy with congenital heart disease developed renal infarction after anticoagulant discontinuation.
- Elevated D-dimer levels and contrast-enhanced CT confirmed the diagnosis of renal infarction.
- The case suggests that anticoagulant discontinuation in such patients may increase the risk of renal infarction.

## Abstract

Renal infarctions are rare in pediatric patients. While cardiogenic risk has been documented in adults, the association between renal infarction and congenital heart disease in children is seldom reported. Consequently, the pathogenesis and risk remain unclear. This report aims to highlight a potential association between anticoagulant discontinuation and renal infarction in pediatric patients with congenital heart disease. Herein, we present the case of a nine-year-old boy who underwent Fontan surgery for a left-sided, morphologic right ventricle and for whom anticoagulants were discontinued following oral bleeding. The patient presented with sudden abdominal pain and was diagnosed with renal infarction based on his medical history and contrast-enhanced CT findings. Serum D-dimer levels were later found to be elevated. Anticoagulant discontinuation in patients with congenital heart disease is a risk factor for renal infarction, necessitating intensified monitoring. In at-risk patients, renal infarction should be considered in the differential diagnosis of acute abdomen.