Asymptomatic intracardiac thrombus in steroid-sensitive nephrotic syndrome

Weisz, Wanja; Kemper, Markus J.; Weil, Jochen; Müller‐Wiefel, D. E.

doi:10.1007/s00467-002-0831-4

Cited by 18 publications

(19 citation statements)

References 14 publications

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“…In a large survey including 3,177 children with NS, Egli et al found 1.8% of various thromboembolic complications, including two patients with CSVT, and reported on one of them [14,15]. However, the prevalence of thromboembolism in NS is thought to be underestimated [23,52]. Divekar et al have observed a single case of CSVT among 700 hundred consecutive patients with NS [12].…”

Section: Discussionmentioning

confidence: 96%

Cerebral sinovenous thrombosis and idiopathic nephrotic syndrome in childhood: report of four new cases and review of the literature

2006

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Section: Discussionmentioning

confidence: 96%

Cerebral sinovenous thrombosis and idiopathic nephrotic syndrome in childhood: report of four new cases and review of the literature

2006

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“…In most reported cases of thromboembolic events in NS, treatment with high-dose heparin with or without thrombolytic agents, has been found to be effective in resolution of thrombus. 4) So for these patients, long-term anticoagulant therapy is particularly important.…”

Section: Discussionmentioning

confidence: 99%

Myocardial Infarction in a Young Man With Nephrotic Syndrome

Chu¹,

Zhu²,

Zhang³

et al. 2017

Int. Heart J.

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SummaryA 26-year-old man diagnosed with nephrotic syndrome (NS) 2 years previously presented with chest pain. An electrocardiogram (ECG) performed at a local hospital showed ST-elevation in chest leads. Cardiac troponin-I was significantly positive. Echocardiography revealed mild regional wall-motion abnormalities in the heart apex. Seven days later, angiography (CAG) revealed a thrombus in the left anterior descending branch (LAD). Tirofiban was injected into the LAD for thromboclasis. ECG after CAG showed the ST-segment was much lower than before. The diagnosis after CAG was ST-segment elevation myocardial infarction (MI) and thrombogenesis in the LAD. He continued to receive antiplatelet and anticoagulation medication and atorvastatin after CAG, and was discharged 3 days later. MI is very rare in young males, but the incidence of MI is 8 times higher than normal in patients with NS. For young patients with MI, clinicians should pay more attention to the history of previous diseases with high risk of thromboembolism and they should actively promote prevention and the treatment of renal disease patients to reduce the incidence of complications of thromboembolism. (Int Heart J 2017; 58: 275-278) Key words: Acte coronary events, Hypercoagulation M yocardial infarction (MI) is very rare in young males. Unlike older patients, in whom the rupture of an atherosclerotic plaque causing occlusion of the coronary artery is the main underlying pathology, the pathogenesis in younger patients can be varied, one of which is thromboembolism caused by nephrotic syndrome. We present here a case of MI in a young male. Case ReportA 26-year-old man presented to the emergency department with chest pain lasting 17 hours, preceded by cough for 7 days. He was diagnosed with nephrotic syndrome (NS) 2 years previously at Xiangya Second Hospital, and was being treated with prednisone to which he responded for about 12 weeks without any subsequent follow-up. He refused a kidney pathological examination at that time. There was no history of diabetes mellitus, hypertension, hepatitis B, malignant tumor, allergic purpura, systemic lupus erythematosus, connective tissue disease, or smoking. Before being transferred to our hospital, he was diagnosed with acute anterior myocardial infarction and an electrocardiogram (ECG) (Figure 1) at a local hospital showed ST-elevation in the chest leads. At the time of presentation, his blood pressure was 128/70 mmHg, his pulse rate 105 beats per minute, and his body temperature 36.7°C. Heart, lung, and abdominal examinations were negative. An ECG showed ST-elevation in the chest leads (Figure 2). Cardiac troponin-I (cTn-I) and MB isoenzyme of creatine kinase (CK-MB) were significantly positive. The provisional diagnosis was ST-segment elevation myocardial infarction (STEMI), with possible severe myocarditis. He refused primary percutaneous coronary angiography (CAG) because his chest pain relieved after he arrived at our hospital. Bedside echocardiography revealed mild regional wall-motion abnormalities...

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“…Intracardiac location of thrombus in NS patients is extremely rare (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). To date, intracardiac thrombi have been reported in 15 patients (3, 6-18); in 5 adults (7-11) and 10 children (3, 6, 12-18).…”

Section: Pathophysiology and Incidence Of Thrombosis In Nephrotic Synmentioning

confidence: 99%

“…Such clinical manifestations may be even absent and the patients might be asymptomatic or with a subclinical course (13,17,18). …”

Section: Clinical Manifestationsmentioning

confidence: 99%

See 1 more Smart Citation

Intracardiac Thromboembolic Complications in Nephrotic Syndrome

Skálová

2017

J Compr Ped

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Asymptomatic intracardiac thrombus in steroid-sensitive nephrotic syndrome

Cited by 18 publications

References 14 publications

Cerebral sinovenous thrombosis and idiopathic nephrotic syndrome in childhood: report of four new cases and review of the literature

Cerebral sinovenous thrombosis and idiopathic nephrotic syndrome in childhood: report of four new cases and review of the literature

Myocardial Infarction in a Young Man With Nephrotic Syndrome

Intracardiac Thromboembolic Complications in Nephrotic Syndrome

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