Low-molecular-weight heparin successfully used to treat a nephrotic patient complicated by superior mesenteric vein thrombosis and portal vein thrombosis.
OBJECTIVE
To report the success of treatment with low- molecular-weight heparins (LMWHs) in a case of nephrotic syndrome complicated by mesenteric vein thrombosis (MVT) and portal vein thrombosis (PVT).


METHODS
A 53-year-old man with nephrotic syndrome developed persistent mild abdominal pain for 3 days. Hepatic-portal venous system thrombosis of nephrotic syndrome was suspected due to new-onset superficial vein engorgement of the abdomen without liver cirrhosis. Abdominal computed tomography revealed MVT concomitant with PVT. He was successfully treated with LMWH without thrombolytic therapy. After discharge on day 9, he received continuous anticoagulation by LWMH on an outpatient basis at the nephrology clinic. Venous thromboembolic events or proteinuria did not recur within the 6-month follow-up.


CONCLUSIONS
This report showed a case of MVT concomitant with PVT, a critical complication of nephrotic syndrome that was diagnosed in time and successfully treated with LMWH. A high index of clinical suspicion and timely management are crucial to tackle thrombotic complications in nephrotic syndrome.
Chang Gung University College of Medicine, Gueishan, Taiwan, Republic of China.
Yi-Chun
YC
Wang
Feng-Rong
FR
Chuang
Wen-Chin
WC
Lee
Te-Chuan
TC
Chen
Sheung-Fat
SF
Ko
I-Kuan
IK
Wang
Chih-Hsiung
CH
Lee
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001713:Biphenyl Compounds / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D000077405:Irbesartan; D008297:Male; D017538:Mesenteric Artery, Superior / Q000473:pathology*; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000150:complications* / Q000473:pathology; D011169:Portal Vein / Q000473:pathology*; D011239:Prednisolone / Q000627:therapeutic use; D013777:Tetrazoles / Q000627:therapeutic use; D020246:Venous Thrombosis / Q000188:drug therapy*
D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D005938:Glucocorticoids; D006495:Heparin, Low-Molecular-Weight; D013777:Tetrazoles; D011239:Prednisolone; D000077405:Irbesartan