Chonnam Med J.  2013 Apr;49(1):50-53. 10.4068/cmj.2013.49.1.50.

Successfully Treated Femoral Artery Thrombosis in a Patient with Minimal Change Nephrotic Syndrome

• Lee JK
• Baek MS
• Mok YM
• Kim SA
• Lim BJ
• Lee JE
• Kim H

• KMID: 2172178
• DOI: http://doi.org/10.4068/cmj.2013.49.1.50

Abstract

In contrast to widely recognized venous thrombotic complications, peripheral arterial thrombosis as a complication of nephrotic syndrome, especially without preceding iatrogenic venous puncture, corticosteroid treatment, or coagulation factor abnormalities, has rarely been reported in adult female patients. We report the case of a 39-year-old woman who presented with pain in the right lower leg accompanied by minimal change nephrotic syndrome. Lower-extremity angiography showed total occlusion of the right superficial femoral artery. Thrombectomy was performed with a balloon catheter, and the thrombi were successfully aspirated. Our experience indicates that even if few traditional risk factors for atherosclerosis are identified, a high index of suspicion and aggressive treatment of arterial thrombosis in adult nephrotic syndrome are crucial to minimize serious ischemic injuries.

Keyword

Nephrotic syndrome; Nephrosis, lipoid; Peripheral arterial disease

MeSH Terms

Adult
Angiography
Atherosclerosis
Blood Coagulation Factors
Catheters
Female
Femoral Artery
Humans
Leg
Nephrosis, Lipoid
Nephrotic Syndrome
Peripheral Arterial Disease
Punctures
Risk Factors
Thrombectomy
Thrombosis
Blood Coagulation Factors

Figure

• 

  FIG. 1 Lower-extremity CT angiography showed occlusion of the right popliteal artery and the ostial portions of the anterior tibial, posterior tibial, and peroneal arteries.

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  FIG. 2 The right lower-extremity arteriogram showed a complete occlusion with a filling defect of the superficial femoral artery.

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  FIG. 3 The second arteriogram of the right lower extremity after thrombectomy. Revascularized distal superficial femoral artery and a good distal arterial flow were observed.

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  FIG. 4 Under light microscopy, although there were some glomeruli with mildly increased glomerular size and focal mild hypercellularity involving endothelial cells, all of the glomeruli appeared grossly normal [hematoxylin and eosin (HE) stain. ×400].

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  FIG. 5 Electron microscopy showed focal marked effacement of the podocyte foot processes without electron-dense deposits and the normal width of glomerular basement membrane.

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