A Case Report of Extensive Cerebral Venous Sinus Thrombosis as a Presenting Sign of Relapsing Nephrotic Syndrome

Lee, Janet K.; Murray, Kathleen; Renati, Swetha

doi:10.1155/2019/6840240

Cited by 4 publications

(1 citation statement)

References 13 publications

(14 reference statements)

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“…The mechanism is still not clear. It is basically caused due to imbalance in the procoagulant and anticoagulant factors 4. It is caused by deficiencies of key haemostatic regulatory elements such as antithrombin and free protein S and elevated levels of high molecular weight pro-coagulation factors like factor V, factor VIII, von Willebrand factor and fibrinogen.…”

Section: Discussionmentioning

confidence: 99%

Sixth cranial nerve palsy and dense cerebral venous sinus thrombosis in a child with nephrotic syndrome

2023

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Nephrotic syndrome (NS) is a common glomerular disease characterised by massive proteinuria, hypoalbuminaemia, oedema and hyperlipidaemia. Cerebral venous sinus thrombosis (CVST) is a rare complication in children with NS. Here, we report a case of relapsing NS on steroid therapy, in a male in early childhood who presented with symptoms of headache, vomiting and double vision. On prism cover test there was 25 PD esotropia with abduction restriction in the left eye. Fundus examination showed bilateral papilloedema. He was diagnosed as sixth cranial nerve palsy of left eye. Neuroimaging reported dense CVST. He was managed with subcutaneous low molecular weight heparin and steroids. After 2 months of treatment, there was a complete resolution of esotropia and optic disc oedema. This case highlights the importance of early diagnosis of acute onset esotropia and sagittal sinus thrombosis in a case of NS.

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Section: Discussionmentioning

confidence: 99%

Sixth cranial nerve palsy and dense cerebral venous sinus thrombosis in a child with nephrotic syndrome

2023

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The influence of risk factors on the development of atherotrombotic stroke and cerebral venous thromboses

Belova¹,

Машин²,

Sitnikova³

et al. 2022

Acta Phlebol

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Case report: cerebral venous sinus thrombosis and pulmonary embolism as the initial presentation in a child with asymptomatic primary nephrotic syndrome

et al. 2023

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BackgroundCerebral venous sinus thrombosis (CVST) is rare, but potentially life-threatening. The clinical course definitely become more unpredictable and fatal in patients complicated by pulmonary embolism (PE). Nephrotic syndrome (NS) is an uncommon etiology of CVST. Concurrence of CVST and PE at the initial onset of NS is extremely unusual and rarely reported. Considering that edema might be absent in NS individuals, thromboembolic events probably become unrecognized, thereby causing a missed or delayed diagnosis and poor outcome. Herein, we described an extraordinary case of an adolescent boy presenting with both CVST and PE initially just within 5 days of disease onset, who was ultimately diagnosed with asymptomatic NS, aiming to emphasize a high index of suspicion of these diseases in patients with conditions of hypercoagulability.Case presentationA 13-year-old male child presented acutely with dizziness, fever and dyspnea, with signs of shock but undetected edema. Initial laboratory investigations revealed hypoalbuminemia, typical images of pneumonia, and normal radiographic findings on non-enhanced computed tomography of head. Despite evidence of hypoalbuminemia and neurological symptoms, the child was still misdiagnosed as pneumonia. His dyspnea and period of headache deteriorated even if hemodynamic stability and undetected fever after initial therapy. The delayed urinalysis and 24-h urine examination both showed massive proteinuria. A computed tomography angiography of chest along with cranial magnetic resonance imaging/magnetic resonance venography were subsequently performed, consistent with the imaging features of PE and CVST, respectively. The diagnosis of asymptomatic primary NS complicated by PE and CVST was ultimately confirmed. The patient received corticosteroids and antithrombotic therapy with satisfactory results.ConclusionA persistent clinical suspicion of CVST should be borne in mind in patients with a sudden, new or worsening headache, specifically among those with prothrombotic conditions. NS should always be considered in the differential diagnosis of risk factors for CVST, even in absence of edema. Since CVST and PE can be present simultaneously at extraordinary early-onset of NS, early radiological diagnosis is clinically substantial to proper management and satisfactory long-term outcomes.

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A Case Report of Extensive Cerebral Venous Sinus Thrombosis as a Presenting Sign of Relapsing Nephrotic Syndrome

Cited by 4 publications

References 13 publications

Sixth cranial nerve palsy and dense cerebral venous sinus thrombosis in a child with nephrotic syndrome

Sixth cranial nerve palsy and dense cerebral venous sinus thrombosis in a child with nephrotic syndrome

The influence of risk factors on the development of atherotrombotic stroke and cerebral venous thromboses

Case report: cerebral venous sinus thrombosis and pulmonary embolism as the initial presentation in a child with asymptomatic primary nephrotic syndrome

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