title: Unusual presentation of renal vein thrombosis with pulmonary artery embolism.
abstract: A young 23-year-old male patient presented with a two-day history of right flank pain. He had no history of any significant illnesses in the past. His investigations showed nephrotic range proteinuria with hypoalbuminemia. The patient developed cough and shortness of breath after having a left kidney biopsy. He did not respond to regular respiratory tract infection treatment. The kidney biopsy revealed membranoproliferative glomerulonephritis. Further investigations for the cough showed thromboembolism of the posterior and lateral basal segments of the right lower lobe. Moreover he was found to have thrombosis of the right upper pole renal vein. The patient was started on full anticoagulation along with three days pulse steroid, followed by 1 mg/kg oral steroid. Clinical improvement was noticed within 48 h. After eight weeks the proteinuria decreased from 8.5 gm/day to 1.1 gm/day. The kidney function was normal with eGFR 145 mL/min through the course of the disease. This case represent one of the unusual presentation of nephrotic syndrome with pulmonary and renal vascular thromboembolic events. The response to the combination of anticoagulation and steroid was remarkable.
authors: Department of Nephrology and Internal Medicine, Bahrain Specialist Hospital, Manama, Kingdom of Bahrain.
authors: Khaled
authors: K
authors: Mzayen
authors: Jafar
authors: J
authors: Al-Said
authors: Shobhana
authors: S
authors: Nayak-Rao
authors: Maria Teresa
authors: MT
authors: Catacutan
authors: Olfat
authors: O
authors: Kamel
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001706:Biopsy; D021501:Flank Pain / Q000209:etiology; D015432:Glomerulonephritis, Membranoproliferative / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D010690:Phlebography / Q000379:methods; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D020551:Pulse Therapy, Drug; D012082:Renal Veins / Q000000981:diagnostic imaging; D013256:Steroids / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D013256:Steroids