Korean J Med.  2010 Nov;79(5):577-582.

A case of aortic thromboembolism and fresh nephrotic syndrome

• Ahn BM
• Lee DH
• Oh SE
• Kim JK
• Lee N
• Lee YK
• Noh JW

Abstract

Nephrotic syndrome has frequently been associated with complications of thrombosis. Hypercoagulability is known as the principal contributing factor in the pathophysiologic mechanism, but the precise mechanism is unclear. Venous thrombosis is frequently recognized, but arterial thrombosis is rare, especially in the abdominal aorta. Most cases of arterial thrombosis present with acute ischemic symptoms and develop into a relapsing phase of nephrotic syndrome. The mainstream treatment for all abdominal aortic thrombosis patients is an emergency thrombectomy and thrombolytic therapy. We report on a 63-year-old male patient who was referred for malignant hypertension. The patient had no symptoms of claudication or peripheral ischemia. We diagnosed nephrotic syndrome using the laboratory data and detected a thrombosis involving the abdominal aortic, left renal and both iliac arteries. Because the patient had a single functioning kidney, we did not perform a kidney biopsy. We consider that the hypercoagulability state in nephrotic syndrome was caused by the abdominal aorta and peripheral arterial thrombosis. The patient's symptoms improved after anticoagulation and conservative therapy.

Keyword

Thrombosis; Nephrotic syndrome; Aorta

MeSH Terms

Aorta
Aorta, Abdominal
Biopsy
Emergencies
Humans
Hypertension, Malignant
Iliac Artery
Ischemia
Kidney
Male
Middle Aged
Nephrotic Syndrome
Thrombectomy
Thromboembolism
Thrombolytic Therapy
Thrombophilia
Thrombosis
Venous Thrombosis