Etoh Yuki, Ohsawa Isao, Fujita Takayuki, Fuke Yoshinobu, Endo Morita, Ohi Hiroyuki, Kumasaka Kazunari
Internal Medicine II, Nihon University School of Medicine, Tokyo, Japan.
Nephron. 2002;92(3):680-4. doi: 10.1159/000064107.
Thromboembolism is known as a major complication of nephrotic syndrome, but only 4 cases of portal vein thrombosis have been reported as a complication of nephrotic syndrome. All of these 4 cases had acute symptoms, and 3 of 4 were in relapsing phase of nephrotic syndrome when thrombi were found. We describe here a case of 51-year-old woman with fresh nephrotic syndrome that was asymptomatically complicated by portal, splenic and renal vein thrombosis.
In the presence of fresh nephrotic syndrome of minimal change, asymptomatic and widely distributed, including portal vein, thrombus formation occurred. If the clinical course shows resistance to therapy, we must consider the complication of venous thrombosis. Anticoagulant therapy with heparin and warfarin was effective and all thrombi disappeared without any other complications.
血栓栓塞是肾病综合征的主要并发症，但仅有4例门静脉血栓形成作为肾病综合征的并发症被报道。这4例均有急性症状，其中4例中有3例在发现血栓时处于肾病综合征的复发期。我们在此描述1例51岁患有新发肾病综合征的女性，其无症状地合并门静脉、脾静脉和肾静脉血栓形成。
在新发微小病变型肾病综合征患者中，出现了无症状且广泛分布（包括门静脉）的血栓形成。如果临床病程显示对治疗有抵抗，我们必须考虑静脉血栓形成这一并发症。肝素和华法林抗凝治疗有效，所有血栓均消失且无任何其他并发症。
