Nandish Shailesh S, Khardori Romesh, Elamin Elamin M
Department of Medicine, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9636, USA.
Am J Med Sci. 2006 Jul;332(1):32-5. doi: 10.1097/00000441-200607000-00006.
Thrombotic complications in patients with nephrotic syndrome are attributed to a hypercoagulable state. Venous thrombosis is common, but arterial thrombosis occurs less frequently in adult nephrotic patients. We report a case of recurrent transient ischemic attacks as an initial manifestation of nephrotic syndrome due to early-stage membranous glomerulonephritis, review the literature for similar cases, and briefly discuss this potentially life-threatening condition. We observed that transient ischemic attack or ischemic stroke could be the initial manifestation of nephrotic syndrome. Our observation may serve as reminder to consider nephrotic syndrome as a possible contributor when evaluating patients with transient ischemic attacks with no other discernable clues. A high index of suspicion alone avoids the unnecessary withholding of prophylaxis or treatment that can be life saving.
肾病综合征患者的血栓形成并发症归因于高凝状态。静脉血栓形成很常见，但成年肾病患者动脉血栓形成的发生率较低。我们报告了一例因早期膜性肾小球肾炎导致肾病综合征的首发表现为复发性短暂性脑缺血发作的病例，回顾了类似病例的文献，并简要讨论了这种潜在的危及生命的疾病。我们观察到短暂性脑缺血发作或缺血性中风可能是肾病综合征的首发表现。我们的观察结果可能提醒人们，在评估无其他明显线索的短暂性脑缺血发作患者时，要考虑肾病综合征可能是一个病因。仅高度怀疑就能避免不必要地不进行可能救命的预防或治疗。
