J Korean Pediatr Soc.  1999 Jul;42(7):1019-1025.

A Childhood Case of Nephrotic Syndrome Complicated with Cerebral Venous Sinus Thrombosis Followed by Left Popliteal Artery Thrombosis

• Lee SE
• Lee SJ
• Jung YS
• Lim JY
• Park CH
• Woo HO
• Yoo JJ
• Youn HS

Abstract

We report a 10-year-old male with steroid-responsive nephrotic syndrome which was complicated by cerebral venous sinus thrombosis including superior sagittal sinus and left popliteal artery thrombosis following 5 months later. At each thrombotic episode, he suffered from relapse of massive proteinuria with hypovolemic crisis, and from hemoconcentration with dehydration due to vomiting or diarrhea. Brain MR angiography confirmed thromboses of superior sagittal sinus, straight sinus, vein of Galen and occipital sinus. Diagnosis of left popliteal artery thrombosis was made according to the clinical observations including pulseless left dorsalis pedis artery, pain and coldness of left lower leg, and reperfusion injury of calf muscle after heparinization. Each thrombotic episode was successfully managed with heparinization, oral warfarin therapy and fresh frozen plasma for the antithrombin III replacement.

Keyword

Steroid responsive nephrotic syndrome; Cerebral venous sinus; Superior sagittal sinus; Popliteal artery; Thrombosis

MeSH Terms

Angiography
Antithrombin III
Arteries
Brain
Cerebral Veins
Child
Dehydration
Diagnosis
Diarrhea
Heparin
Humans
Hypovolemia
Leg
Male
Nephrotic Syndrome*
Plasma
Popliteal Artery*
Proteinuria
Recurrence
Reperfusion Injury
Sinus Thrombosis, Intracranial*
Superior Sagittal Sinus
Thrombosis*
Vomiting
Warfarin
Antithrombin III
Heparin
Warfarin