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KMID : 0882420070730040448
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Korean Journal of Medicine
2007 Volume.73 No. 4 p.448 ~ p.452
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Successful systemic thrombolysis of both the inferior vena cava and a renal vein thrombi that complicated nephrotic syndrome
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Lee Hyung-Seok
Kim Jin-Taek
Min Joo-Won
Kwon Ghee-Young
Kim Bong-Soo
Choi Guk-Myung
Kang Woo-Heon
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Abstract
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Nephrotic syndrome has been considered a hypercoagulable state because thromboembolic events of the venous or the
arterial circulations occur on occasion. There are various risk factors for thromboembolism in patients with nephrotic
syndrome (membranous nephropathy, severe hypoalbuminemia, hemoconcentration and medications such as steroid and
diuretics). As thromboembolism is often fatal, early detection and proper management are important. Although
anticoagulation is the preferred therapy, thrombolysis may be considered for an extensive thrombosis, for inferior vena
cava (IVC) thrombosis, for recurrent pulmonary thromboembolism and for bilateral renal vein thrombosis in conjunction
with acute renal failure. We report here on a case of renal vein and IVC thrombosis in a 24-year-old male with nephrotic
syndrome, and this patient was treated with intravenous thrombolytics rather than anticoagulation and local thrombolytic
infusion. He complained of left flank pain and his CT scan revealed left renal vein thrombosis and IVC thrombosis. After
urokinase infusion, his thrombi were resolved successfully without bleeding complications
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KEYWORD
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Thrombolysis, Thromboembolism, Nephrotic syndrome
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