Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India.
BMJ Case Rep. 2023 Jun 2;16(6):e254044. doi: 10.1136/bcr-2022-254044.
Nephrotic syndrome (NS) is a common glomerular disease characterised by massive proteinuria, hypoalbuminaemia, oedema and hyperlipidaemia. Cerebral venous sinus thrombosis (CVST) is a rare complication in children with NS. Here, we report a case of relapsing NS on steroid therapy, in a male in early childhood who presented with symptoms of headache, vomiting and double vision. On prism cover test there was 25 PD esotropia with abduction restriction in the left eye. Fundus examination showed bilateral papilloedema. He was diagnosed as sixth cranial nerve palsy of left eye. Neuroimaging reported dense CVST. He was managed with subcutaneous low molecular weight heparin and steroids. After 2 months of treatment, there was a complete resolution of esotropia and optic disc oedema. This case highlights the importance of early diagnosis of acute onset esotropia and sagittal sinus thrombosis in a case of NS.
肾病综合征（NS）是一种常见的肾小球疾病，其特征为大量蛋白尿、低白蛋白血症、水肿和高脂血症。脑静脉窦血栓形成（CVST）是儿童 NS 的罕见并发症。在这里，我们报告了一例在类固醇治疗期间复发的 NS 病例，该病例为一名年幼的男性，出现头痛、呕吐和复视的症状。在棱镜遮盖试验中，左眼有 25 PD 的内斜视伴外展受限。眼底检查显示双侧视乳头水肿。他被诊断为左眼第六颅神经麻痹。神经影像学报告为致密性 CVST。他接受了皮下低分子肝素和类固醇治疗。治疗 2 个月后，内斜视和视盘水肿完全消退。本例强调了在 NS 患者中，急性发作性内斜视和矢状窦血栓形成的早期诊断的重要性。
