Nephrotic Syndrome May Be One of the Important Etiologies of Cerebral Venous Sinus Thrombosis

Wang, Yuan; Wang, Mengqi; Duan, Jiangang; Liu, Gang; Chen, Jian; Li, Sijie; Ji, Xunming

doi:10.1016/j.jstrokecerebrovasdis.2016.06.013

Cited by 12 publications

(3 citation statements)

References 49 publications

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“…Eight children who developed nephritis or nephrotic syndrome (hormone therapy) were already in the pre-thrombus state and the occurrence of CVST was attributed to insufficient water intake due to vomiting. These findings are in accordance with those of several other studies in that infection, nephritis, or nephrotic syndrome may be important etiologies of CVST (8, 9). In this study, 63.3% (19/30) of the children presented with obvious cases of the disease, which is far lower than the 85% reported in international studies (10).…”

Section: Discussionsupporting

confidence: 93%

Clinical Characteristics and Outcomes of Pediatric Cerebral Venous Sinus Thrombosis: An Analysis of 30 Cases in China

et al. 2019

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Background: Cerebral venous sinus thrombosis (CVST) in children is rare in a clinical setting. The aim of this study was to summarize the etiological, clinical, and imaging characteristics of CVST in children.Methods: We retrospectively analyzed the data of 30 patients with a diagnosis of CVST who were admitted to Children's Hospital of Fudan University from 2008 to 2018. The medical records, including clinical manifestations, laboratory data, neurological findings, treatment, and short-term prognosis were analyzed.Results: Etiologically, the causes of CVST were infection (7/30), tumor (3/30), nephritis or nephrotic syndrome (8/30), traumatic brain injury (1/30), and undefined disease (11/30). All 30 cases were diagnosed with CVST after a neuroimaging examination using brain magnetic resonance imaging (MRI) combined with magnetic angiography venography (MRV). With regard to short-term prognosis, all the patients were treated with anticoagulants, after which 26 cases improved.Conclusions: CVST patients do not typically present with specific clinical manifestations, which leads to a high rate of misdiagnosis and delayed therapy. Increased consideration and prompt MRV checkup plays a key role in achieving an accurate diagnosis. Overall, anticoagulation is a safe and effective treatment for CVST.

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Section: Discussionsupporting

confidence: 93%

Clinical Characteristics and Outcomes of Pediatric Cerebral Venous Sinus Thrombosis: An Analysis of 30 Cases in China

et al. 2019

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“…In our review of the literature, there are few documented cases of cerebral thrombosis in the context of adult MCD. Only 10 cases involved cerebral venous sinus thrombosis [6][7][8][9][10][11][12][13][14]. Patients were 20 to 68 years old, with one patient having documented prothrombotic risk factors of OCP use and smoking history.…”

Section: Discussionmentioning

confidence: 99%

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

Lee

Murray

Renati

2019

Case Reports in Neurological Medicine

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Nephrotic syndrome is defined by three characteristic features including proteinuria of >3 g in 24 hours, hypoalbuminemia of less than 3 g/dL, and peripheral edema. Multiple nephropathies can result in nephrotic syndrome. Most commonly, minimal change disease is seen in children under the age of 10, while adults are more commonly found to have membranous nephropathy. Hypercoagulability and thrombotic sequela can be seen in nephrotic syndrome, regardless of underlying etiology, and thrombosis is most commonly seen in deep veins of the lower extremities and renal veins. Our case identifies an adult with previously diagnosed and treated for minimal change disease who presented with weight gain, peripheral edema, foamy urine, headache but no neurologic deficits. The patient was found to have near to complete occlusion of the entire superior sagittal sinus, near complete occlusion of the left transverse and sigmoid sinuses, and nonocclusive thrombus in the right sigmoid sinus. She was treated with heparin and IV steroids then transitioned to warfarin and PO steroids, respectively, with resolution of symptoms. This case report emphasizes on the importance of recognizing CVST as a potential complication of nephrotic syndrome at both initial presentation and relapse.

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“…Although arterial thrombosis occurs mostly in children, the occurrence of strokes, especially ischemic stroke (IS), is not uncommon in adult patients with NS [ 3 , 4 ]. Several case reports [ 3 – 6 ] and retrospective cohort studies [ 7 , 8 ] suggest that patients with NS have an increased risk of IS and venous sinus thrombosis.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of ischemic stroke and intracranial hemorrhage in patients with nephrotic syndrome

et al. 2021

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Background The incidence of cerebral stroke, including ischemic infarction and intracranial hemorrhage (ICH), increases in patients with nephrotic syndrome (NS). However, the clinical characteristics of patients with NS and stroke remain elusive. We aimed to investigate the clinical presentation and prognosis among patients with NS and ischemic stroke (IS) or ICH. Methods We conducted a population-based retrospective cohort study of patients with NS and acute stroke using the Chang Gung Research Database of Taiwan from January 1, 2001, to December 31, 2017. The participants were recruited from the 7 branches of Chang Gung Memorial Hospital. Results A total of 233 patients with IS and 57 patients with ICH were enrolled. The median age was 60 (52–70) years. The prevalence rates of hyperlipidemia, hyperuricemia, and smoking were higher in IS than in ICH. IS demonstrated lower white blood cell count (7.80 vs. 8.92 × 109/L) and high-sensitivity C-reactive protein level (33.42 vs. 144.10 nmol/L) and higher cholesterol (5.74 vs. 4.84 mmol/L), triglyceride (1.60 vs. 1.28 mmol/L), and albumin (24 vs. 18 g/L) levels compared with ICH. The dependent functional status and 30-day mortality were higher in ICH than in IS. The risk factors for 30-day mortality for patients with NS and stroke were coronary artery disease (CAD), ICH, and total anterior circulation syndrome. The multivariate Cox regression analysis revealed that CAD was positively associated with 30-day mortality in patients with IS (hazard ratio 24.58, 95 % CI 1.48 to 408.90). In patients with ICH, CAD and subarachnoid hemorrhage were positively associated with 30-day mortality (hazard ratio 5.49, 95 % CI 1.54 to 19.56; hazard ratio 6.32, 95 % CI 1.57 to 25.53, respectively). Conclusions ICH demonstrated a higher risk of dependence and 30-day mortality compared with IS in patients with NS. Intensive monitoring and treatment should be applied particularly in patients with NS and ICH.

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Nephrotic Syndrome May Be One of the Important Etiologies of Cerebral Venous Sinus Thrombosis

Cited by 12 publications

References 49 publications

Clinical Characteristics and Outcomes of Pediatric Cerebral Venous Sinus Thrombosis: An Analysis of 30 Cases in China

Clinical Characteristics and Outcomes of Pediatric Cerebral Venous Sinus Thrombosis: An Analysis of 30 Cases in China

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

Characteristics of ischemic stroke and intracranial hemorrhage in patients with nephrotic syndrome

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