The association of renal vein thrombosis and proteinuria´ was first described by the French nephrologist, Rayer, in 1840. Since then, several hundred cases have been recorded in the literature. We report 1 case of neprotic syndrome with renalvein thrombosis during, pregnany egnancy. To the best knowle ge of the authors this is the first case of the kind ever reported in the literature in this country.
A 27 year -old pregnant woman was admitted because of generalized edema and left flank pain. The patient showed generalized edema, hypoproteinemia, hyperlipidemia and -massive ,proteinuria, which were typical findings of neprotic syndrome. The longitudinal axis of the left kidney was 15cm in KUB and also observed aseptic pyuria, marked fluctuation of creatinine clearance and 24 hr urine protein. A percutaneous, biopsy of the left kidney revealed mesangial proliferative glomerulonephritis.
Left and right selective ureteral urine specimen showed, 1637mg/300ml, 836mg/250m1 respectively in protein. content Renal venography revealed that the left renal vein was partially obliterated by thrombi and there were well developed periureteral and pericapsular collateral veins. Serum: comple ment profiles, C3, C4, C3 activators, were checked but their clinical significance was not appreciated,
Above findings suggested that renal vein thrombosis was triggered by hypercoagulability, due to nephrotic syndrome and was further aggravated by pregnancy. Nephrotic syndrome must have been also aggravated by renal vein thrombosis, so that, a vicious cycle was maintained.
This patient was treated with wafarin and prednisolone, but we think steroid is poor choice of treatment, because of its thrombotic effect.
|