A large intracardiac thrombus in a child with steroid-resistant nephrotic syndrome

2012 ◽  
Vol 23 (3) ◽  
pp. 440-442 ◽  
Author(s):  
Filiz Ekici ◽  
Nilgün Çakar

AbstractIntracardiac thrombus is a rare complication of nephrotic syndrome in children, and only a few cases have been reported. We report the case of a 3.5-year-old child diagnosed with Henoch–Schönlein Purpura and steroid-resistant nephrotic syndrome for 2 months. The patient had massive oedema but no cardiovascular instability. Echocardiography displayed a large thrombus within the right atrium and the patient was successfully managed with enoxoparine.

2018 ◽  
Vol 13 (3) ◽  
pp. 145-146
Author(s):  
M.A. MARTAKOV ◽  
E.M. ZAJNETDINOV ◽  
V.P. PRONINA ◽  
N.V. SHESTERIKOV ◽  
V.V. SHESTERIKOVA ◽  
...  

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Hai-bo Yan ◽  
Yu-mei Li

Abstract Background Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple systems with various clinical manifestations. Renal involvement is common, but intracardiac thrombus is rarely reported as a complication of antiphospholipid syndrome (APS, also known as anticardiolipin syndrome). Anticoagulant therapy is the first-line treatment, and surgery is performed in severe cases. We report a case to improve clinicians’ understanding of disease diagnosis. Case presentation An 8-year-old girl was admitted to our hospital because of left costal pain, hematuria and fever. She had obvious edema occult blood 3+, urinary protein 3.2 g/24 h, albumin 17.6 g/L, and total cholesterol 7.21 mmol/L, consistent with a diagnosis of nephrotic syndrome. We continued to track the etiology of nephrotic syndrome and performed a renal biopsy, showing dsDNA 1:10 positivity, low C3, low platelets and hemoglobin, anticardiolipin IgM 12 U/ml, anti-β2-glycoprotein I (β2GPI) 223 U/ml; renal pathology suggested lupus nephritis (LN), and the patient was ultimately diagnosed with SLE, secondary APS and LN. The patient was treated with hormones and immunosuppressants. Sixteen weeks later, her urinary protein was 1+, and the quantity of urine protein was less than 0.5 g/d. Echocardiography showed that the mass in the right atrium was thrombotic. Heparin anticoagulant therapy was effective. Conclusion SLE can involve multiple systems and various complications. Thrombus in the right atrium is a rare complication of APS. Early diagnosis and treatment are key to improving the prognosis of children.


2018 ◽  
Vol 31 ◽  
Author(s):  
Abdelkader Jalil El Hangouche ◽  
Oumaima Alaika ◽  
Koffi Augustin Assié ◽  
Latifa Oukerraj ◽  
Nawal Doghmi ◽  
...  

2019 ◽  
Vol 35 (4) ◽  
pp. 621-623
Author(s):  
Lale Guliyeva ◽  
Yılmaz Tabel ◽  
Ali Düzova ◽  
Nusret Akpolat ◽  
Seza Özen ◽  
...  

Nephron ◽  
2021 ◽  
pp. 1-6
Author(s):  
Suramath Isaranuwatchai ◽  
Ankanee Chanakul ◽  
Chupong Ittiwut ◽  
Chalurmpon Srichomthong ◽  
Vorasuk Shotelersuk ◽  
...  

Chronic kidney disease of unknown etiology (CKDu) has been a problem in renal practice as indefinite diagnosis may lead to inappropriate management. Here, we report a 54-year-old father diagnosed with CKDu at 33 years old and his 8-year-old son with steroid-resistant nephrotic syndrome. Using whole-exome sequencing, both were found to be heterozygous for c.737G>A (p.Arg246Gln) in LMX1B. The diagnosis of LMX1B-associated nephropathy has led to changes in the treatment plan with appropriate genetic counseling. The previously reported cases with this particular mutation were also reviewed. Most children with LMX1B-associated nephropathy had nonnephrotic proteinuria with normal renal function. Interestingly, our pediatric case presented with steroid-resistant nephrotic syndrome at 8 years old and progressed to ESRD requiring peritoneal dialysis at the age of 15 years. Our report emphasized the need of genetic testing in CKDu for definite diagnosis leading to precise management.


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