Thromboembolic complications at the onset of nephrotic syndrome

Kumar, Mritunjay; Malhotra, Amber; Gupta, Sourabh; Singh, Ragini

doi:10.24911/sjp.2017.2.8

Cited by 7 publications

(3 citation statements)

References 8 publications

(8 reference statements)

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“…The review of the international literature [1][2][3][4][5][6][7][8][9] reveals that the majority of patients are male. Although their clinical manifestations are diverse, they mostly present with headache and vomiting.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis in a Child With Idiopathic Nephrotic Syndrome: A Case Report and Review of the Literature

He¹,

Yang²

2020

Cureus

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Cerebral venous sinus thrombosis is a rare and serious complication of nephrotic syndrome. A case of a five-year-old boy with nephrotic syndrome is described here. On the fourth day of admission, the child developed an occasional cough. A percutaneous renal biopsy was conducted to characterize the frequent-relapse nephrotic syndrome that was developed. After suspension of oral anticoagulants, the patient developed mild dizziness, headache, and vomiting. The child was diagnosed with intracranial venous sinus thrombosis based on data obtained using head computed tomography and magnetic resonance imaging. He recovered after receiving heparin and warfarin anticoagulants. We summarized the case and reviewed the literature here, showing that early diagnosis and treatment have a significant impact on the prognosis of this complication.

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Section: Discussionmentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis in a Child With Idiopathic Nephrotic Syndrome: A Case Report and Review of the Literature

He¹,

Yang²

2020

Cureus

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“…Thromboembolic complications have been frequently reported in patients with long-lasting nephrotic syndrome. 8 Serious clotting factor disturbances can be observed, such as changes in platelet hyperfunction, increased plasma fibrinogen, abnormalities of the fibrinolytic system, and acquired deficiencies of coagulation inhibitors. However, increased platelet aggregation and antithrombin III deficiency are the most important factors in this hypercoagulable state in nephrotic syndrome.…”

Section: Discussionmentioning

confidence: 99%

Acute anterior myocardial infarction in a 22-year-old male nephrotic patient along with familial hyperlipidaemia

Zeng

Zhang

2018

Cardiol Young

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We report a case of acute myocardial infarction in a nephrotic male patient. A 22-year-old man with a 1-year history of nephrotic syndrome due to membranous nephropathy presented with acute chest pain and was admitted to our emergency room. An electrocardiogram showed ST elevation in leads consistent with anterior and inferior myocardial infarction. Subsequent cardiac catheterisation showed evidence of thrombotic occlusion of the anterior descending coronary artery. The patient had no long history of hypercholesterolaemia or hypertriglyceridaemia. The case suggests that young patients with a short-term nephrotic syndrome may be at an increased risk for acute coronary syndrome owing to hypercoagulability state.

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“…Furthermore, irrespective of etiology, the rate of PE has been estimated to be 1.4% in patients with CVST (13). Occurrence of CVST and PE with evidence of NS is extremely unusual and rarely reported (14). Moreover, as for the time point of occurrence of VTE in patients with NS, it occurs prevalently as part of the disease course or as a consequence of the pharmacological treatment, more frequently in relapsing NS or steroid resistant NS (15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

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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Thromboembolic complications at the onset of nephrotic syndrome

Cited by 7 publications

References 8 publications

Cerebral Venous Sinus Thrombosis in a Child With Idiopathic Nephrotic Syndrome: A Case Report and Review of the Literature

Cerebral Venous Sinus Thrombosis in a Child With Idiopathic Nephrotic Syndrome: A Case Report and Review of the Literature

Acute anterior myocardial infarction in a 22-year-old male nephrotic patient along with familial hyperlipidaemia

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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