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      Intraventricular and Brachial Artery Thrombosis in Nephrotic Syndrome

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          A 23-year-old Saudi female presented with nephrotic syndrome. On renal biopsy she had primary focal and segmental glomerulosclerosis which was resistant to steroids. Two years later she presented with absent left arm pulses and on investigation a diagnosis of left ventricular thrombosis and thromboembolism of left brachial artery was made. Low antithrombin III, high fibrinogen levels and diuretic therapy were the possible causative factors for hypercoagulable state. On anticoagulation therapy initiated with heparin and continued with warfarin for 8 weeks there was complete dissolution of intraventricular and improvement of left brachial artery thrombosis. An early diagnosis and treatment of this potentially serious complication of nephrotic syndrome are stressed.

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          On the incidence of renal vein thrombosis in the nephrotic syndrome.

           A Koffler,  F Llach,  E Finck (1977)
          Forty-eight patients with nephrotic syndrome were evaluated prospectively; the studies included inferior venacavagrams and ventilation perfusion lung scans. Eleven patients were found to have renal vein thrombosis (RVT). Eight of 21 patients with membranous glomerulonephritis (MGN) or membranoproliferative glomerulonephritis (MPGN) has RVT (38%). Clinical, laboratory, and pathological findings were not different among those patients with MGN and MPGN whether RVT was present or not. Patients with diabetic nephropathy or lupus nephritis did not have RVT. There was a high incidence of other thromboembolic phenomena as well as asymptomatic perfusion defects demonstrated by the lung scan, especially in patients with MGN or MPGN. These data suggest the disease process underlying the nephrotic syndrome may play a paramount role in the genesis of RVT or thromboembolic phenomena.

            Author and article information

            Am J Nephrol
            American Journal of Nephrology
            S. Karger AG
            April 1998
            01 April 1998
            : 18
            : 2
            : 142-145
            Divisions of a Nephrology and b Cardiology, Department of Medicine, Security Forces Hospital, Riyadh, Kingdom of Saudi Arabia
            13323 Am J Nephrol 1998;18:142–145
            © 1998 S. Karger AG, Basel

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            Page count
            Figures: 3, References: 29, Pages: 4
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/13323
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