Medical Principles and Practice
Case Report
Inferior Vena Cava Filter as a Preventive Device for Recurrent Pulmonary Embolism in a Patient with Nephrotic SyndromeTsai Y.-C.a · Hsieh Y.-K.b · Lee C.-T.aDivisions of aNephrology and bCardiology, Department of Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC
Dr. Chien-Te Lee Division of Nephrology, Department of Internal Medicine Chang-Gung Memorial Hospital, Kaohsiung, 123 Ta-Pei Road Niao-Sung Hsiang, Kaohsiung Hsien 833, Taiwan (ROC) Tel. +886 7 731 7123, ext. 8306, Fax +886 7 732 2402, E-Mail ctlee33@adm.cgmh.org.tw |
|
Abstract
Objective: This study describes a patient with nephrotic syndrome who experienced recurrent pulmonary emboli as renal disease relapsed frequently. Clinical Presentation: A 30-year-old male, who was diagnosed as having nephrotic syndrome at 12, presented with general edema, ascites and hypoalbuminemia. Although the patient responded well to steroid therapy, a common cold frequently caused flare-up of nephrotic syndrome. Histopathological examination of renal tissue revealed minimal disease change. At 17, the patient had a first pulmonary embolism attack with concurrent upper respiratory tract infection. Full-blown manifestations of nephrotic syndrome with low antithrombin III levels were identified at that time. Anticoagulant therapy was administered to treat the pulmonary embolism. Since the first attack, several episodes of pulmonary emboli occurred, which, combined with kidney disease, triggered refractory nephrotic syndrome. The nephrotic syndrome did not remit, and a secondary renal biopsy identified glomerular pathological changes similar to previous biopsy results. To prevent recurrent pulmonary emboli, a Greenfield inferior vena cava filter was implanted in April 2002. No further pulmonary embolism events occurred after interventional filter deployment. Conclusion: The results of this study suggest that inferior vena cava filter implantation can be effective for preventing recurrent pulmonary embolism complicating refractory nephrotic syndrome.
© 2007 S. Karger AG, Basel
Related Articles:
References
- Fogo AB: Minimal change disease and focal segmental glomerulosclerosis. Nephrol Dial Transplant 2001;16:74–76.
- Llach F: Hypercoagulability, renal vein thrombosis, and other thrombotic complications of nephrotic syndrome. Kidney Int1985;28:429–439.
- Carson JL, Kelley MA, Duff A: The clinical course of pulmonary embolism. N Engl J Med 1992;326:1240–1245.
-
Bargman JM: Management of minimal lesion glomerulonephritis: evidence-based recommendations. Kidney Int 1999;70:S3–S16.
External Resources
- Chuang CH, Lee CT, Cheng YF, Huang TL, Hung KH, Chen JB: Bilateral renal infarctions and lower limbs artery thrombosis in a patient with nephrotic syndrome. J Nephrol 2004;17:311–315.
- Goldhaber SZ: Pulmonary embolism. N Engl J Med1998;339:93–104.
- Vaziri ND: Acquired deficiency and urinary excretion of antithrombin III in nephrotic syndrome. Arch Intern Med 1984;144:1802–1803.
- Decousus H, Leizorovicz A, Parent F, Page Y, Tardy B, Girard P, Laporte S, Faivre R, Charbonnier B, Barral FG, Huet Y, Simonneau G: A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. New Engl J Med 1998;338:409–415.
- Greenfield LJ, Proctor MC: Twenty-year clinical experience with Greenfield filter. Cardiovasc Surg 1995;3:199–205.
- O’Brien AA, O’Donnell JP, Keogh JA: Renal vein thrombosis with recurrent pulmonary emboli in the nephrotic syndrome: use of Greenfield filter. Postgrad Med J 1986;62:223–225.
Article / Publication Details
Received: June 18, 2006
Accepted: October 28, 2006
Published online: June 06, 2007
Issue release date: June 2007
Number of Print Pages: 3
Number of Figures: 0
Number of Tables: 0
ISSN: 1011-7571 (Print)
eISSN: 1423-0151 (Online)
For additional information: https://www.karger.com/MPP
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Get Permission
PubMed ID
