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Renal venous thrombosis (RVT) is a well-recognised and potentially fatal entity in children, and approximately 80% of RVTs present in the first month of life.1 Management of RVT remains controversial. Anticoagulation or thrombolytic therapy is recommended for bilateral RVT, unilateral RVT with extension of the clot into the inferior vena cava, or impending renal failure.2 We report a case of bilateral RVT in a premature infant who was treated with recombinant tissue plasminogen activator (r-TPA) and had a good outcome with eventual complete recovery.
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