Enalapril-induced acute retal failure and jugular venous thrombosis associated with a homozygous methylene tetrahydrofolate reductase A1298C polymorphisms in a newborn with central venous line: Case report

A full term newborn having no underlying renal disease developed acute renal failure (ARF) after starting of oral enalapril (0.01mg/kg/day) given for the treatment of congestive heart failure (CHF). After peritoneal dialyses, she recovered from ARF. The patient treated due to yen tilatory associated pneumonia, sepsis and candidemia, developed left juguler venous thrombosis as sociated with central venous line by day 51 of life. Enoxaparine dose started 1.5 mg/kg/twice daily subcutaneously, was increased until reach recommended therapeutic target range of antifactor Xa. While she was treated with enoxaparine at a dose of 1.9 mg/kg/twice daily, thrombus propa gation was detected at her right juguler vein. Homozygote methylene tetrahydrofolatereductase (MTHFR) gene A1298C polymorphism was detected at the ethiology. Plasma homocysteine level and other prothrombotic components were normal. We suggest that, MTHFR gene A1298C poly morphism might be investigated in infants with ARF, venous thrombosis in spite of normal homo cysteine levels in the presence of prothrombotic risk factors such as CHF, sepsis, and catheter placement.. Copyright © 2013 by Türkiye Klinikleri.