Ikeda S, Takaya Y, Takahashi K, Takaoka M, Makino H, Ota Z
Nihon Jinzo Gakkai Shi. 1989 Aug;31(8):883-9.
A case of nephrotic syndrome found by pulmonary infarction associated with renal vein thrombosis was reported. The renal biopsy showed the presence of membranous glomerulonephritis. The patient had the increase of serum level of the coagulation factor II, V, fibrinogen and FDP, and the level of urine FDP. These laboratory data suggested that the hyper coagulation state of his blood caused by nephrotic state, induced his multiple thromboembolism. We surveyed 47 case report abstracts of nephrotic syndrome patients having thromboembolism on the Japanese Journal of Nephrology published from 1974 to 1986. The histopathology of their renal biopsies showed the high incidence of membranous glomerulonephritis, followed by minimal change nephrotic syndrome and focal glomerular sclerosis. Renal vein thrombosis was the most common thromboembolism in the reports, followed by thrombosis of cerebral vessels, peripheral vessels and pulmonary artery. Some patients died of pulmonary infarction or myocardial infarction. These data showed that we must keep in mind of the possibility of thromboembolism in the treatment of nephrotic syndrome.
报告了一例因肺梗死合并肾静脉血栓形成而发现的肾病综合征病例。肾活检显示存在膜性肾小球肾炎。患者的凝血因子II、V、纤维蛋白原和FDP的血清水平以及尿FDP水平升高。这些实验室数据表明，肾病状态导致的血液高凝状态引发了他的多发性血栓栓塞。我们查阅了1974年至1986年发表在《日本肾脏病学杂志》上的47例有血栓栓塞的肾病综合征患者的病例报告摘要。他们肾活检的组织病理学显示膜性肾小球肾炎的发生率很高，其次是微小病变肾病综合征和局灶性肾小球硬化。肾静脉血栓形成是报告中最常见的血栓栓塞，其次是脑血管、外周血管和肺动脉血栓形成。一些患者死于肺梗死或心肌梗死。这些数据表明，在肾病综合征的治疗中我们必须牢记血栓栓塞的可能性。
