All issues > Volume 42(7); 1999

Case Report

J Korean Pediatr Soc. 1999;42(7):1019-1025. Published online July 15, 1999.

A Childhood Case of Nephrotic Syndrome Complicated with Cerebral Venous Sinus Thrombosis Followed by Left Popliteal Artery Thrombosis

Si-Eun SE Lee¹, Sue-Jin SJ Lee¹, Yang-Suk YS Jung¹, Jae-Young JY Lim¹, Chan-Hoo CH Park¹, Hyang-Ok HO Woo¹, Jin-Jong JJ Yoo², Hee-Shang HS Youn¹

¹Department of Pediatrics, Gyeongsang National University, College of Medicine, Chinju, Korea
²Department of Diagnostic Radiology, Gyeongsang National University, College of Medicine, Chinju, Korea

Correspondence Si-Eun SE Lee ,Email: 1

Abstract

We report a 10-year-old male with steroid-responsive nephrotic syndrome which was complicated by cerebral venous sinus thrombosis including superior sagittal sinus and left popliteal artery thrombosis following 5 months later. At each thrombotic episode, he suffered from relapse of massive proteinuria with hypovolemic crisis, and from hemoconcentration with dehydration due to vomiting or diarrhea. Brain MR angiography confirmed thromboses of superior sagittal sinus, straight sinus, vein of Galen and occipital sinus. Diagnosis of left popliteal artery thrombosis was made according to the clinical observations including pulseless left dorsalis pedis artery, pain and coldness of left lower leg, and reperfusion injury of calf muscle after heparinization. Each thrombotic episode was successfully managed with heparinization, oral warfarin therapy and fresh frozen plasma for the antithrombin III replacement.

Keywords :Steroid responsive nephrotic syndrome, Cerebral venous sinus, Superior sagittal sinus, Popliteal artery, Thrombosis