Abstract
Nephrotic syndrome (NS) is a consequence of the reduced ability of the glomerulus barrier to exclude proteins of intermediate size and other macromolecules from urine. Albumin and proteins that modulate the coagulation cascade are among the substances eliminated in urine. This is responsible of thromboembolic complication. The incidence of this extra renal complication is probably underestimated because of asymptomatic thromboembolic events. We report the case of a 23 years old man followed up for an idiopathic nephrotic syndrome since childhood who presented a large intracardiac thrombus complicated by distal embolisation of his two lower limbs, successfully treated by fogartisation-embolectomy and oral anticoagulation.
Highlights
Nephrotic syndrome is defined as the presence of heavy proteinuria, hypoalbuminemia, hyperlipidemia and peripheral oedema
We report the case of 23 years old man, with a history of idiopathic nephrotic syndrome since childhood treated by corticosteroids
Mahmoodi et Al reported that absolute risks of venous thromboembolism (VTE) (1.02% per year) and arterial thromboembolism (ATE) (1.48% per year) were each approximately 8 times higher in Nephrotic Syndrome patients than in the general population [6]
Summary
Nephrotic syndrome is defined as the presence of heavy proteinuria (protein excretion greater than 3.5g/24h), hypoalbuminemia (less than 3.0g/dl), hyperlipidemia and peripheral oedema. High blood pressure and amyloidosis [1]. This syndrome is associated with an increased risk for thromboembolic complications. We report the case of 23 years old man, with a history of idiopathic nephrotic syndrome since childhood treated by corticosteroids. He was admitted at emergency department for acute pain of his both lower limbs. Physical examination revealed a coldness and pulseless of both lower limbs (abolished bilateral popliteal and distal pulses). His blood pressure was 130/80mmHg, cardiac and lung examination were unremarkable. Repeated echocardiography showed a total dissolution of the thrombosis five weeks later
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