Thrombotic Complications in Childhood-onset Idiopathic Membranous Nephropathy

Overview

Journal Pediatr Nephrol

Specialties Nephrology
Pediatrics

Date 2003 Oct 31

PMID 14586672

Citations 10

Authors

Chrystal U Louis

Bruce Z Morgenstern

Lavjay Butani

Affiliations

Soon will be listed here.

Abstract

While the most common clinical feature of nephrotic syndrome is generalized edema, patients are at risk of developing other problems, such as bacterial infections, electrolyte abnormalities, and venous thromboses. Adults with membranous nephropathy appear to be at the greatest risk for developing thromboses, especially renal vein thrombosis. However, the same is not true for children with membranous nephropathy. A review of pediatric membranous nephropathy stated that renal vein thrombosis is unrecorded in childhood-onset membranous nephropathy. We present our experience in managing two children with idiopathic membranous nephropathy who developed venous thromboses. To our knowledge, this is the first report of pediatric patients with membranous nephropathy to develop a thromboembolic complication without evidence of predisposing factors or coagulation abnormalities. This report emphasizes the need for appropriate evaluation of patients with membranous nephropathy who develop signs and symptoms suggestive of arterial or venous occlusion in order to avoid missing this potentially life-threatening medical complication.

Citing Articles

Arterial Thrombosis Associated with Factor V Leiden Mutation in a Child with Nephrotic Syndrome.

Nagalla V, Raju S, Ramesh Bura N Indian J Nephrol. 2021; 31(2):187-189.

PMID: 34267445 PMC: 8240935. DOI: 10.4103/ijn.IJN_32_18.

Determination of the value of albumin, anti-thrombin III, fibrinogen and D-dimer factors in the diagnosis of asymptomatic pulmonary embolism in patients with nephrotic syndrome.

Nejad N, Sadat Sharif A, Otukesh H, Hosseini Shamsabadi R, Hekmat S, Sakhaei M Pediatr Nephrol. 2021; 36(7):1803-1808.

PMID: 33459936 DOI: 10.1007/s00467-020-04904-w.

Cerebral sinovenous thrombosis in a child with idiopathic nephrotic syndrome.

Ghedira Besbes L, Haddad S, Gabsi A, Hassine M, Ben Meriem C, Guediche M Case Rep Nephrol. 2014; 2011:724950.

PMID: 24533195 PMC: 3914126. DOI: 10.1155/2011/724950.

Acute kidney injury as the first sign of spontaneous renal vein thrombosis: report of 2 cases.

Shumei S, Ling X, Yanxia W, Lei Z, Yuanyuan S J Thromb Thrombolysis. 2011; 33(1):129-32.

PMID: 21904843 DOI: 10.1007/s11239-011-0633-2.

An unusual case of loin pain and nephritis.

Ma A, Lai W, Chiu M Clin Exp Nephrol. 2009; 14(1):75-9.

PMID: 19802521 DOI: 10.1007/s10157-009-0222-2.

References

Alexander F, Campbell W . Congenital nephrotic syndrome and renal vein thrombosis in infancy. J Clin Pathol. 1971; 24(1):27-40. PMC: 478013. DOI: 10.1136/jcp.24.1.27. View

Andrew M, Brooker L . Hemostatic complications in renal disorders of the young. Pediatr Nephrol. 1996; 10(1):88-99. DOI: 10.1007/BF00863459. View

Garbrecht F, Gardner S, Johnson V, Grabowski E . Deep venous thrombosis in a child with nephrotic syndrome associated with a circulating anticoagulant and acquired protein S deficiency. Am J Pediatr Hematol Oncol. 1991; 13(3):330-3. DOI: 10.1097/00043426-199123000-00015. View

Levine J, Branch D, Rauch J . The antiphospholipid syndrome. N Engl J Med. 2002; 346(10):752-63. DOI: 10.1056/NEJMra002974. View

Llach F . Hypercoagulability, renal vein thrombosis, and other thrombotic complications of nephrotic syndrome. Kidney Int. 1985; 28(3):429-39. DOI: 10.1038/ki.1985.149. View

Roth K, Amaker B, Chan J . Nephrotic syndrome: pathogenesis and management. Pediatr Rev. 2002; 23(7):237-48. DOI: 10.1542/pir.23-7-237. View

Jantunen R, Juvonen E, Ikkala E, Oksanen K, Anttila P, Ruutu T . The predictive value of vascular risk factors and gender for the development of thrombotic complications in essential thrombocythemia. Ann Hematol. 2001; 80(2):74-8. DOI: 10.1007/s002770000244. View

Tkaczyk M, Baj Z . Surface markers of platelet function in idiopathic nephrotic syndrome in children. Pediatr Nephrol. 2002; 17(8):673-7. DOI: 10.1007/s00467-002-0865-7. View

Citak A, Emre S, Sairin A, Bilge I, Nayir A . Hemostatic problems and thromboembolic complications in nephrotic children. Pediatr Nephrol. 2000; 14(2):138-42. DOI: 10.1007/s004670050029. View

10.

Lewy P, Jao W . Nephrotic syndrome in association with renal vein thrombosis in infancy. J Pediatr. 1974; 85(3):359-65. DOI: 10.1016/s0022-3476(74)80116-2. View

11.

. Comparison of idiopathic and systemic lupus erythematosus-associated membranous glomerulonephropathy in children. The Southwest Pediatric Nephrology Study Group. Am J Kidney Dis. 1986; 7(2):115-24. View

12.

Lilova M, Velkovski I, TOPALOV I . Thromboembolic complications in children with nephrotic syndrome in Bulgaria (1974-1996). Pediatr Nephrol. 2000; 15(1-2):74-8. DOI: 10.1007/s004679900253. View

13.

Mehls O, Andrassy K, Koderisch J, HERZOG U, Ritz E . Hemostasis and thromboembolism in children with nephrotic syndrome: differences from adults. J Pediatr. 1987; 110(6):862-7. DOI: 10.1016/s0022-3476(87)80397-9. View

14.

Ponticelli C, Zucchelli P, Imbasciati E, Cagnoli L, Pozzi C, Passerini P . Controlled trial of methylprednisolone and chlorambucil in idiopathic membranous nephropathy. N Engl J Med. 1984; 310(15):946-50. DOI: 10.1056/NEJM198404123101503. View

15.

Ramirez F, Brouhard B, Travis L, Ellis E . Idiopathic membranous nephropathy in children. J Pediatr. 1982; 101(5):677-81. DOI: 10.1016/s0022-3476(82)80289-8. View

16.

KELSCH R, Sedman A . Nephrotic syndrome. Pediatr Rev. 1993; 14(1):30-8. DOI: 10.1542/pir.14-1-30. View

17.

Hoyer P, Gonda S, Barthels M, Krohn H, BRODEHL J . Thromboembolic complications in children with nephrotic syndrome. Risk and incidence. Acta Paediatr Scand. 1986; 75(5):804-10. DOI: 10.1111/j.1651-2227.1986.tb10294.x. View

18.

Biousse V . The coagulation system. J Neuroophthalmol. 2003; 23(1):50-62. DOI: 10.1097/00041327-200303000-00011. View

19.

Harris R, Ismail N . Extrarenal complications of the nephrotic syndrome. Am J Kidney Dis. 1994; 23(4):477-97. DOI: 10.1016/s0272-6386(12)80369-6. View

20.

Cameron J . Membranous nephropathy in childhood and its treatment. Pediatr Nephrol. 1990; 4(2):193-8. DOI: 10.1007/BF00858840. View