Markowitz G S, Brignol F, Burns E R, Koenigsberg M, Folkert V W
Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA.
Am J Kidney Dis. 1995 May;25(5):801-6. doi: 10.1016/0272-6386(95)90558-8.
Renal vein thrombosis (RVT) can occur as a complication of the nephrotic syndrome. We present the case of a young woman with systemic lupus erythematosus with nephrotic syndrome and bilateral RVT with extension of the thrombus into the vena cava to the level of the right atrium and multiple pulmonary emboli. She was treated acutely with streptokinase, with complete resolution of the thrombi. In general, anticoagulation is the mainstay of therapy for RVT. Review of the literature reveals that thrombolytic therapy can be used safely and appears to have been reserved for those patients with the most severe disease or the more grave prognosis. we feel that thrombolytic therapy is warranted in the presence of bilateral RVT with acute renal failure, massive clot size with high risk of acute embolic events, or recurrent pulmonary emboli, in the absence of overriding contraindications.
肾静脉血栓形成（RVT）可作为肾病综合征的一种并发症出现。我们报告一例年轻女性系统性红斑狼疮患者，合并肾病综合征及双侧肾静脉血栓形成，血栓延伸至下腔静脉至右心房水平，并伴有多发性肺栓塞。她接受了链激酶急性治疗，血栓完全溶解。一般来说，抗凝治疗是RVT的主要治疗方法。文献回顾显示，溶栓治疗可安全使用，似乎仅用于那些病情最严重或预后最差的患者。我们认为，在存在双侧RVT并伴有急性肾衰竭、巨大血栓且急性栓塞事件风险高或复发性肺栓塞的情况下，在没有绝对禁忌证时，溶栓治疗是必要 的。
