Embolic Stroke and Nephrotic Syndrome: A Case Report and Literature Review

Abstract

Nephrotic syndrome (NS) is less commonly associated with arterial thrombosis than venous thrombosis. We report a case of a 43-yearoldwomanwho presented with an acute embolic stroke confirmed on MRI, about 3 months after the diagnosis of NS. The standard stroke evaluations did not show evidence ofcardiac source of embolism, large vessel atherosclerosis or any primary hypercoagulable disorders. Laboratory tests revealed impaired renal function and extremely high nephrotic range proteinuria and a renal biopsy showed primary membranous glomerulonephropathy. Subsequently, she was discharged on anticoagulation and responded well to the treatment. This case illustrates the importance of considering hypercoagulable evaluation due to nephrotic syndrome as a potential cause of embolic stroke, and the initiation of anticoagulation therapy in a timely manner. We also present a literature review on the association between nephrotic syndrome and acute stroke.