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| 증례 : 미세변화 신증후군에 합병된 간문맥, 비장정맥 및 장간막정맥 혈전증 1예 (Acute Venous Thrombosis of Splenomesenteric Portal Axis in Minimal Change Nephrotic Syndrome) |
| 조종태(Jong Tae Cho),김지훈(Ji Hoon Kim),박정식(Jung Sik Park),이상구(Sang Koo Lee),김순배(Soon Bae Kim),양현숙(Hyun Suk Yang),조경식(Kyoung Sik Cho) |
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| Abstract |
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An association between nephrotic syndrome and thromboembolic phenomena has been known for many years. Most common sites of venous throm-bosis in nephrotic syndrome are al vein and deep vein of lower extremity. We report a case of minimal change nephrotic syndrome associated with unusual extensive venous thrombosis. A 29-year-old man was transferred to our hospital with severe abdominal pain and ascites. 2 months before admission, he was diagnosed as minimal change nephropathy at another hospital and treated with steroid therapy but he had persistent proteinuria on admission. The ab- dominal ultrasonography and CT scan revealed diffuse thrombosis of left renal vein, splenic vein, su-perior mesenteric vein and portal vein. Deep vein thrombosis of lower extremity was also found but not pulmonary embolism. There was no evidence of other primary hypercoagulable disease. He was treat- ed with intravenous heparin immediately and three days later, abdominal pain disappeared. Prednisolone and cyclophosphamide were administered as well. After 1 month of therapy, proteinuria was resolved. Abdominal CT scan, taken after 2 months of therapy, revealed that diffuse thrombosis were almost re- solved. From this case, diffuse abdominal thrombosis should be included as a diffrential diagnosis in a ne-phrotic patient with abdominal pain. |
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