Jeele Mohamed Osman Omar, Addow Rukia Omar Barei, Mohamud Mohamed Farah Yusuf
Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia.
Jazeera University Hospital, Mogadishu, Somalia.
Int J Emerg Med. 2021 Aug 23;14(1):46. doi: 10.1186/s12245-021-00369-2.
Nephrotic syndrome (NS) was first described in 1827 as the presence of proteinuria of ≥ 3.5 g/24 h, hypoalbuminemia < 3.0 g/dl, peripheral edema, hyperlipidemia, lipiduria, and increased thrombotic risk. Nephrotic syndrome has an incidence of three cases per 100,000 each year in adults. Nephrotic syndrome also has serious complications due to hypercoagulable state in both various venous and arteries which could lead thromboembolic events. The pathophysiology of hypercoagulability in the nephrotic syndrome is due to an imbalance of prothrombotic and antithrombotic factors, as well as impaired thrombolytic activities.Here, we will present a 19-year-old woman who presented to the emergency department complaining of chest pain and shortness of breath for 3 days. The patient was quickly diagnosed with pulmonary embolism and inferior vena cava thrombosis as a complication of nephrotic syndrome, allowing prompt initiation of anticoagulant therapy. After 2 weeks of admission, the patient's condition resolved, her laboratory results returned to almost normal and the patient was discharged with oral prednisolone, coumadin, atorvastatin, and ramipril. We aim to determine which is the likely cause of pulmonary embolism in patients with nephrotic syndrome.
肾病综合征（NS）于1827年首次被描述，其特征为24小时蛋白尿≥3.5克、低白蛋白血症<3.0克/分升、外周水肿、高脂血症、脂尿症以及血栓形成风险增加。肾病综合征在成年人中的发病率为每年每10万人中有3例。由于肾病综合征患者处于高凝状态，在各种动静脉中均会引发严重并发症，可能导致血栓栓塞事件。肾病综合征高凝状态的病理生理学是由于促血栓形成和抗血栓形成因子失衡，以及溶栓活性受损。在此，我们将介绍一名19岁女性，她因胸痛和气短3天就诊于急诊科。该患者很快被诊断为肾病综合征并发症导致的肺栓塞和下腔静脉血栓形成，随即迅速开始抗凝治疗。入院2周后，患者病情好转，实验室检查结果几乎恢复正常，患者出院时带药口服泼尼松龙、华法林、阿托伐他汀和雷米普利。我们旨在确定肾病综合征患者肺栓塞的可能病因。
