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A Case of Cerebral Infarcion due to Thrombosis Associated with Focal Segmental Glomerulosclerosis and Steroid Resistant Nephrotic Syndrome

Journal of the Korean Pediatric Society 1994;37(9):1317-1324.
Published online September 15, 1994.
A Case of Cerebral Infarcion due to Thrombosis Associated with Focal Segmental Glomerulosclerosis and Steroid Resistant Nephrotic Syndrome
Dae Woo Kim, Heon Lang Park, Sang Man Shin, Eun Mi Kim
Department of Pediatrics, School of Medicine, Soon Chun Hyang University, Seoul, Korea
스테로이드 저항성 신증후군/국소성 분절성 사구체 경화증에 병발된 혈전증에 의한 뇌경색증 1례
김대우, 박헌랑, 신상만, 김은미
순천향대학교 의과대학 소아과학교실
Abstract
Focal segmental glomerulosclerosis is the renal histopathologic lesion observed in 10% of children with idopathic nephrotic syndrome. Complications include infection, thrombosis, hypocalcemia and adverse effect of steroid use. The incidnce of thrombosis reported ranges from 10~40%. The pathogenesis are changes in coagulation system, decrease of Antithrombin III, increase platelet aggregability and steroid or diuretics use. These changes take place passively as a result of increased protein synthesis and urinary loss of low molecular weight protein. We experienced a case of cerebral infarction due to thrombosis associated with focal segmental glomerulosclerosis and steroid resistant nephrotic syndrome in a 11 year old male patient who had been hospitalized because of convulsion and semicoma. MRI showed an evolving infarct in the occipital lobe, decreased antithrombin III and increased factor VIII on coagulation factor assay. We hereby report a case of cerebral infarction due to thrombosis associated with focal segmental glomerulosclerosis and steroid resistant nephrotic syndrome with a brief review of related literature.
Key Words: Focal segmental glomerulosclerosis, Steroid resistant nephrotic syndrome, Cerebral thrombosis


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