Korean J Nephrol.  2000 May;19(3):537-541.

Acute Venous Thrombosis of Splenomesenteric Portal Axis in Minimal Change Nephrotic Syndrome

• Yang HS
• Kim JH
• Kim SB
• Lee SK
• Cho KS
• Park JS
• Cho JT

Abstract

An association between nephrotic syndrome and thromboembolic phenomena has been known for many years. Most common sites of venous throm-bosis in nephrotic syndrome are al vein and deep vein of lower extremity. We report a case of minimal change nephrotic syndrome associated with unusual extensive venous thrombosis. A 29-year-old man was transferred to our hospital with severe abdominal pain and ascites. 2 months before admission, he was diagnosed as minimal change nephropathy at another hospital and treated with steroid therapy but he had persistent proteinuria on admission. The abdominal ultrasonography and CT scan revealed diffuse thrombosis of left renal vein, splenic vein, superior mesenteric vein and portal vein. Deep vein thrombosis of lower extremity was also found but not pulmonary embolism. There was no evidence of other primary hypercoagulable disease. He was treated with intravenous heparin immediately and three days later, abdominal pain disappeared. Prednisolone and cyclophosphamide were administered as well. After 1 month of therapy, proteinuria was resolved. Abdominal CT scan, taken after 2 months of therapy, revealed that diffuse thrombosis were almost resolved. From this case, diffuse abdominal thrombosis should be included as a diffrential diagnosis in a nephrotic patient with abdominal pain.

Keyword

Abdominal pain; Venous thrombosis; Nephrotic syndrome

MeSH Terms

Abdominal Pain
Adult
Ascites
Axis, Cervical Vertebra*
Cyclophosphamide
Diagnosis
Heparin
Humans
Lower Extremity
Mesenteric Veins
Nephrosis, Lipoid*
Nephrotic Syndrome
Portal Vein
Prednisolone
Proteinuria
Pulmonary Embolism
Renal Veins
Splenic Vein
Thrombosis
Tomography, X-Ray Computed
Ultrasonography
Veins
Venous Thrombosis*
Cyclophosphamide
Heparin
Prednisolone