Fatal Neonatal Bilateral Renal Vein Thrombosis with Inferior Vena Cava Extension: A Rare Cause of Acute Renal Failure

Introduction : Neonatal renal vein thrombosis is an uncommon condition that can result in acute renal failure and long-term complications, particularly in cases of bilateral involvement extending to the inferior vena cava (IVC). This case report underscores the challenges of managing neonatal bilateral renal vein thrombosis in resource-limited settings. Case presentation: We report a 15-day-old neonate who presented with a 10-day history of gross hematuria and acute renal failure. Ultrasound confirmed the presence of bilateral renal vein thrombosis extending to the inferior vena cava and the right hepatic artery. The infant was managed with supportive care and unfractionated heparin. However, due to the challenges in critical care management, the condition deteriorated, resulting in a fatal outcome. Conclusion: Bilateral neonatal renal vein thrombosis is a rare, life-threatening condition with high morbidity and mortality. Although other factors may have contributed to the poor outcome, this case also may suggest that the absence of thrombolysis in severe bilateral cases played a role. Further research is needed to guide effective management and improve outcomes in low-resource settings like Somalia.