1/69. Bilateral renal vein and inferior vena cava thrombosis with nephrotic syndrome treated by thrombectomy: case report with 3-year followup.A previously healthy 19-year-old woman taking anovulatory medication presented with symptoms of the nephrotic syndrome and lupus erythematosus. diagnosis of inferior vena cava and bilateral renal vein thrombosis was made angiographically. The patient was treated successfully by thrombectomy and anticoagulation, and remains well 3 years later. Laboratory data indicate normal renal function and only mild proteinuria. This is the longest followup of a patient with this entity reported in the literature.- - - - - - - - - - ranking = 1keywords = nephrotic syndrome (Clic here for more details about this article) |
2/69. Peripheral arterial thrombosis in systemic lupus erythematosis and nephrotic syndrome: possible association with protein s deficiency.Arterial thrombosis in systemic lupus erythematosus (SLE) and nephrotic syndrome have been infrequently reported. A 16-year-old boy with SLE and longstanding nephrotic syndrome presented with peripheral arterial thrombosis when his lupus was at an inactive stage. He did not have antiphospholipid antibodies but had low serum antithrombin III and protein S levels. We suggest that the thrombotic event is not related to antiphospholipid antibodies but to nephrotic syndrome and possibly to acquired protein s deficiency.- - - - - - - - - - ranking = 1.4keywords = nephrotic syndrome (Clic here for more details about this article) |
3/69. Renal thrombotic microangiopathy associated with interferon-alpha treatment of chronic myeloid leukemia.Recent reports have documented the development of renal thrombotic microangiopathy in patients with chronic myeloid leukemia (CML) who have undergone treatment with interferon-alpha. The pathogenesis of the renal lesion in such cases remains unclear. We report the case of a patient with chronic myeloid leukemia who developed renal failure and nephrotic syndrome while being treated with hydroxyurea and interferon-alpha. The renal biopsy showed features of chronic thrombotic microangiopathy. The patient had serologic and functional evidence of anti-phospholipid antibody. interferon-alpha is known to cause induction of multiple autoantibodies. We propose that in the context of CML, interferon-alpha treatment can induce pathogenic anti-phospholipid antibodies that result in renal thrombotic microangiopathy. This has important implications for patients with CML receiving immune-stimulating therapy because it suggests that prospective monitoring of such patients for anti-phospholipid antibody might identify those at risk of developing thrombotic microangiopathy. Furthermore, patients with established anti-phospholipid antibody syndrome in this context might benefit from intervention such as early anticoagulation.- - - - - - - - - - ranking = 0.2keywords = nephrotic syndrome (Clic here for more details about this article) |
4/69. Acute arterial thrombosis with antithrombin iii deficiency in nephrotic syndrome: report of a case.nephrotic syndrome frequently causes venous thromboembolic complications. Arterial thrombosis has rarely been reported and is mainly observed in children. Only six cases of lower extremity arterial thrombosis in adults have been reported in the literature. The outcome in these cases was unsatisfactory because of the high rates of limb loss and recurrence of thrombosis. We report successful treatment of a 39-year-old man who suffered from right lower extremity arterial thrombosis associated with decreased levels of serum antithrombin III. He was admitted to our hospital with severe pain in his right foot. No pulse was palpable in his right dorsalis pedis or posterior tibial arteries. His right foot was cold and mottled, with a reduced sensation and motor activity. The laboratory data revealed a serum total protein concentration of 3.9g/dl and an albumin concentration of 1.5 g/dl. The coagulation profile showed a fibrinogen level of 879 mg/dl and antithrombin III value of 9.5%. Right lower extremity arteriography showed a complete occlusion of the right deep femoral artery and popliteal artery, and a filling defect in the common femoral artery. An emergency thrombectomy was performed under general anesthesia. The patient was treated successfully, and surgical treatment was followed by anticoagulant therapy with 1,000 units of antithrombin III. A renal biopsy revealed histologic evidence of minimal change of glomerulonephritis. He was discharged 3 months later, and no recurrence of thrombosis has yet been observed.- - - - - - - - - - ranking = 0.8keywords = nephrotic syndrome (Clic here for more details about this article) |
5/69. Catastrophic exacerbation of antiphospholipid syndrome after lung adenocarcinoma biopsy.We describe a 60-year-old man with nephrotic syndrome due to a glomerular thrombotic microangiopathy caused by the antiphospholipid syndrome (APS) associated with a lung adenocarcinoma. Although no significant aggravation of APS was noted following renal biopsy, catastrophic exacerbation of APS occurred 3 days after a lung adenocarcinoma biopsy while warfarin and prednisolone were being administered. The patient died of multiple organ failure 37 days after the lung adenocarcinoma biopsy. This case emphasizes the need for great caution for catastrophic exacerbation of malignancy associated APS following biopsy of the underlying malignancy.- - - - - - - - - - ranking = 0.2keywords = nephrotic syndrome (Clic here for more details about this article) |
6/69. Acute poststreptococcal glomerulonephritis associated with thrombotic microangiopathy in an adult.The simultaneous occurrence of acute poststreptococcal glomerulonephritis and thrombotic microangiopathy is rare. A 47-year-old woman was admitted with acute renal failure, hematuria, edematous nephrotic syndrome and severe hypertension. This acute nephritic syndrome occurred two weeks after left leg erysipelas. The patient also had signs of intravascular hemolysis, low serum levels of C3 and C4 and elevated antistreptolysin-O titer. kidney biopsy confirmed postinfectious glomerulonephritis with diffuse hypercellularity and humps, and simultaneous subendothelial hyalin deposits and fibrinoid arteriolar thrombi. The patient received four antihypertensive drugs, acetylsalicyclic acid and plasma infusions. Renal function improved, hypertension was controlled and serum levels of C3 and C4 complement components returned to normal within three months. This case illustrates the occurrence of thrombotic microangiopathy in association with acute poststreptococcal glomerulonephritis. This simultaneous appearance supports a role of neuraminidase in this disease.- - - - - - - - - - ranking = 0.2keywords = nephrotic syndrome (Clic here for more details about this article) |
7/69. nephrotic syndrome caused by protein thrombi in glomerulocapillary lumen in Waldenstrom's macroglobulinaemia.Waldenstrom's macroglobulinaemia (WM) is described as a disorder of plasmacytoid lymphocytes. The renal complications of WM are less common and severe than those of multiple myeloma. We present a case of WM complicated by nephrotic syndrome. A biopsy specimen of the kidney revealed the intraglomerular thrombi of immunoglobulin m paraprotein. Corticosteroid pulse therapy and plasmapheresis were effective in improving proteinuria and reducing protein thrombi. The nephrotic syndrome caused by protein thrombi in WM may be reversible, at least in its early stage.- - - - - - - - - - ranking = 0.4keywords = nephrotic syndrome (Clic here for more details about this article) |
8/69. Concurrent thrombosis of cerebral and femoral arteries in a patient with nephrotic syndrome.Although venous thrombosis is a frequently encountered problem in nephrotic syndrome, the occurrence of arterial thrombosis is much less common, and is usually associated with a poor prognosis. To the best of our knowledge, there has been only one reported case of concurrent cerebral and femoral artery thrombosis, that of a 23-year-old male who finally died. Herein, we report a case of a 35-year-old woman with nephrotic syndrome. She developed cerebral and femoral arterial thrombosis simultaneously when the nephrotic syndrome relapsed. Immediate thrombectomy of the femoral artery, followed by anticoagulation and immunosuppressive therapy, were employed. The patient recovered completely and is now doing well. Our experience indicates that multiple artery thrombosis in nephrotic patients may not necessarily carry a poor outcome if early and aggressive treatment can be undertaken.- - - - - - - - - - ranking = 1.4keywords = nephrotic syndrome (Clic here for more details about this article) |
9/69. nephrotic syndrome due to thrombotic microangiopathy (TMA) as the first manifestation of human immunodeficiency virus infection: recovery before antiretroviral therapy without specific treatment against TMA.BACKGROUND: Among the possible renal complications that can develop a human immunodeficiency virus- (hiv) infected patient, thrombotic microangiopathy (TMA) is one of them. This is a type of vascular lesion more common in hiv patients than in normal population, and sometimes it can be the first manifestation of the hiv infection. methods: We present a patient with TMA in whom the subsequent investigation to find the cause of TMA revealed hiv infection and giardia lamblia in stool. RESULTS: Before antiretroviral therapy was started the patient began to show recovery of the hemolytic anemia, recovery of the nephrotic syndrome and partial remission of the proteinuria, so that he did not receive specific therapy for TMA. CONCLUSIONS: hiv infection should be suspected in patients presenting with TMA, and a hiv test should be routinely performed as part of the initial clinical evaluation of TMA. If the patients have not developed acquired immunodeficiency syndrome, the prognosis of TMA is equal to non-infected ones.- - - - - - - - - - ranking = 0.2keywords = nephrotic syndrome (Clic here for more details about this article) |
10/69. A giant left ventricular thrombus in a patient with acute myocardial infarction--a case report.The authors report a patient with acute anteroseptal myocardial infarction with a giant left ventricular thrombus at the apex. The patient also had nephrotic syndrome due to diabetic nephropathy. coronary angiography showed 90% stenosis at segment 6 of the left anterior descending coronary artery. Percutaneous transluminal coronary angioplasty and intracoronary stenting were performed on the 30th day, and effective coronary blood flow was obtained. heparin was injected intravenously for the first 7 days, and warfarin was administered thereafter. The left ventricular thrombus disappeared after 46 days. No evidence of arterial thromboembolism was found during the disappearance of the left ventricular thrombus as determined by echocardiography.- - - - - - - - - - ranking = 0.2keywords = nephrotic syndrome (Clic here for more details about this article) |
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