Journal of Medicine and Life Science

Institute for Medical Science (제주대학교 의과학연구소)
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Acute aortoiliac thrombosis in minimal change disease

  • Soyoung Lee (Division of Nephrology, Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine) ;
  • Hwarim Kang (Division of Nephrology, Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine) ;
  • Jongho Shin (Division of Nephrology, Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine) ;
  • Kyeong Min Kim (Division of Nephrology, Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine)
  • Received : 2022.07.19
  • Accepted : 2022.09.14
  • Published : 2022.12.31
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Abstract

Patients with nephrotic syndrome (NS) are generally known to be at greater risk for thrombosis, with arterial thrombosis-related complications being relatively rare compared to venous thrombosis-related complications. This report describes a 46-year-old male with historically proven minimal change disease (MCD) complicated by acute aortoiliac thrombosis. He had been diagnosed with MCD 8 months previously and was treated successfully with steroids. He was prescribed a second course of high-dose steroids (prednisolone 1 mg/kg/day) due to a relapse of MCD at the outpatient clinic 8 days before the emergency department visit. The patient presented with severe pain in both lower limbs and was diagnosed with aortoiliac thrombosis that developed during high-dose steroid treatment. He subsequently underwent surgical thromboembolectomy. Hypoalbuminemia has the strongest association with the risk of thromboembolism. According to international clinical practice guidelines, anticoagulant therapy is recommended when serum albumin is ≤2-2.5 g/dL. However, as serum albumin levels may be relatively high in the early phase of NS, as in this case report, an individualized anticoagulation strategy for each patient should be considered, regardless of serum albumin levels.

Keywords

Acknowledgement

This case was approved by the Institutional Review Board (IRB) of Daejeon Eulji Medical Center (IRB No. EMC 2021-04-007) and the IRB waived informed consent for this reporting.

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