Document Detail


Nephrotic syndrome presenting as deep vein thrombosis or pulmonary embolism.
MedLine Citation:
PMID:  18356368     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A patient presenting with a swollen left leg and pleuritic chest pain was shown to have deep vein thrombosis (DVT) by Doppler studies. He was anticoagulated but required two further admissions with swelling of both legs before a diagnosis of nephrotic syndrome was considered and confirmed. Renal biopsy showed that this was caused by membranous nephropathy. Two audits were subsequently conducted. The first was of diagnostic discharge codes for nephrotic syndrome and venous thromboembolism in south west Scotland (population 147,000) from 1997 to 2006. A diagnosis of nephrotic syndrome was confirmed in 32 patients, four (12.5%) of whom (including the index case) had presented with DVT (two) or pulmonary embolus (PE) (two). A second audit of 98 consecutive patients with Doppler-positive lower limb DVT presenting to A&E in Dumfries from July 2005 to July 2006 showed that the urine had been tested for protein in one case only. Although nephrotic syndrome remains an uncommon cause of DVT or PE, it is complicated by venous thromboembolism sufficiently frequently for the diagnosis to be considered in all patients with DVT or PE, for whom the take-home message should simply be-Don't forget to dip the urine or ignore a low serum albumin.
Authors:
Bill Ambler; Sharon Irvine; Vik Selvarajah; Chris Isles
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  25     ISSN:  1472-0213     ISO Abbreviation:  Emerg Med J     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-21     Completed Date:  2008-06-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  241-2     Citation Subset:  IM    
Affiliation:
Medical Unit, Dumfries & Galloway Royal Infirmary, Dumfries DG1 4AP, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Humans
Male
Nephrotic Syndrome / diagnosis*
Proteinuria / diagnosis
Pulmonary Embolism / diagnosis*
Venous Thrombosis / diagnosis*

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