Document Detail


Nephrotic syndrome complicated by life-threatening pulmonary embolism in an adult patient.
MedLine Citation:
PMID:  20123597     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report a 23-year-old male presenting with edema. He was originally admitted for an elective renal biopsy for diagnosis of renal pathology. Unfortunately, because of acute abdominal pain an exploratory laparotomy was done. Progressive azotemia and oliguria then developed, and he required temporary hemodialysis. However, he suffered from sudden-onset severe respiratory distress, and blood gas analysis showed profound hypoxemia with a marked arterial-alveolar oxygen difference. Assessment of a pulmonary embolism by radioisotope imaging was not possible because of his dependence on mechanical ventilation. Subcutaneous low molecular weight heparin and intravenous methylprednisolone were given to treat the presumed pulmonary embolism and the underlying nephrotic syndrome. His partial oxygen level gradually increased after continuous heparin and steroid administration. Complete obliteration of one major pulmonary artery and partial obliteration of other smaller arteries were revealed by magnetic resonance angiography. He was discharged and followed-up as an outpatient, and was given oral warfarin and prednisolone. Follow-up magnetic resonance angiography 5 months later showed a normal pulmonary tree with no residual lesions.
Authors:
Szu-Chia Chen; Wan-Chun Liu; Cheng-Hsueh Lee; Jer-Ming Chang; Hung-Chun Chen
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Kaohsiung journal of medical sciences     Volume:  26     ISSN:  1607-551X     ISO Abbreviation:  Kaohsiung J. Med. Sci.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-05-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100960562     Medline TA:  Kaohsiung J Med Sci     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  89-95     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Heparin, Low-Molecular-Weight / therapeutic use
Humans
Magnetic Resonance Angiography
Male
Nephrotic Syndrome / complications*,  drug therapy
Pulmonary Artery / radiography
Pulmonary Embolism / drug therapy,  etiology*,  radiography
Young Adult
Chemical
Reg. No./Substance:
0/Heparin, Low-Molecular-Weight

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