Nayak Shobhana G, Satish Renuka
Department of Nephrology, St. John's Medical College Hospital, Bangalore, India.
Saudi J Kidney Dis Transpl. 2008 Jan;19(1):90-3.
An increased risk of venous thromboembolism has been demonstrated following renal transplantation. Commonly reported sites have been deep vein thrombosis, pulmonary thromboembolism and vascular thrombosis involving the graft. Cerebral venous thrombosis (CVT) has not been reported in literature so far. A 36-year-old male patient, transplanted in Jan 2005 with normal graft functions, was admitted with history of headache, blurring of vision and vomiting. Examination revealed papilledema and no neurological deficits. Baseline investigations and analysis of cerebrospinal fluid were normal. Cerebral magnetic resonance venogram revealed extensive CVT involving superior sagittal sinus, bilateral transverse sinuses and the right sigmoid sinus. He was investigated for a thrombophilic disorder; serum homocysteine, protein C and S levels, antiphospholipid antibody and antithrombin-III levels were done despite which no conclusive diagnosis could be arrived at. To our knowledge, this is the first report of extensive CVT described in a transplant recipient. No definite prothrombotic or predisposing factors could be identified in our patient and the cause of CVT remains unclear.
肾移植后静脉血栓栓塞风险增加已得到证实。常见的发病部位有深静脉血栓形成、肺血栓栓塞和累及移植物的血管血栓形成。迄今为止,文献中尚未报道过脑静脉血栓形成(CVT)。一名36岁男性患者于2005年1月接受移植,移植物功能正常,因头痛、视力模糊和呕吐入院。检查发现视乳头水肿,无神经功能缺损。基线检查和脑脊液分析均正常。脑磁共振静脉造影显示广泛的CVT累及上矢状窦、双侧横窦和右侧乙状窦。对其进行了血栓形成倾向疾病的检查;检测了血清同型半胱氨酸、蛋白C和S水平、抗磷脂抗体和抗凝血酶III水平,但仍无法得出明确诊断。据我们所知,这是首例在移植受者中描述的广泛CVT报告。在我们的患者中未发现明确的促血栓形成或易感因素,CVT的病因仍不清楚。