Unusual presentation of renal vein thrombosis with pulmonary artery embolism

Autor: Khaled Mzayen, Jafar Al-Said, Shobhana Nayak-Rao, Maria Teresa Catacutan, Olfat Kamel
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Zdroj: Saudi Journal of Kidney Diseases and Transplantation, Vol 24, Iss 3, Pp 566-570 (2013)
Druh dokumentu: article
ISSN: 1319-2442
DOI: 10.4103/1319-2442.111068
Popis: A young 23-year-old male patient presented with a two-day history of right flank pain. He had no history of any significant illnesses in the past. His investgations showed nephrotic range proteinuria with hypoalbuminemia. The patient developed cough and shortness of breath after having a left kidney biopsy. He did not respond to regular respiratory tract infection treat-ment. The kidney biopsy revealed membranoproliferative glomerulonephritis. Further investigations for the cough showed thromboembolism of the posterior and lateral basal segments of the right lower lobe. Moreover he was found to have thrombosis of the right upper pole renal vein. The patient was started on full anticoagulation along with three days pulse steroid, followed by 1 mg/kg oral steroid. Clinical improvement was noticed within 48 h. After eight weeks the proteinuria decreased from 8.5 gm/day to 1.1 gm/day. The kidney function was normal with eGFR 145 mL/min through the course of the disease. This case represent one of the unusual presentation of nephrotic syndrome with pulmonary and renal vascular thromboembolic events. The response to the combination of anticoagulation and steroid was remarkable.
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