Case Reports of the Pulmonary Artery Thrombosis and the Cerebral Artery Thrombosis in Two Nephrotic Patients
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An increased coagulability of blood could be induced not only by nephrotic syndrome itself but by the therapeutic administration of corticotropine (ACTH) and cortisone. The use of modern diuretic agents and of immunosuppressive ones seemed to make the coagulation mechanism more complexed. As a result it was not so infrequent that nephrotic patients did die suddenly from the thromboembolic complications.This paper reports two cases of pulmonary artery thrombosis and cerebral artery thrombosis in nephrotic patients who died suddenly.Case 1. 25yrs. old male; There was edema in legs at the age of 23yrs. Two years had passed without any symptoms, but marked edema in legs reappeared and he developed edema on the face and discomfortness in anterior chest on exertion. He was admitted to our hospital with a diagnosis of nephrotic syndrome. Laboratory examination revealed marked proteinuria, hypoalbuminemia, hyperlipemia and the decrease in renal functions. During the hospitalization he was given diuretics, decholesterol agents, predonisolone and rinderon. However, serum total protein and cholesterol level were not changed. On the 115'th hospital day he suddenly complained discomfortness of chest and expired after three hours. Autopsy revealed extensive fresh and organized thrombosis of pulmonary arteries and focal glomerulonephritis.Case 2. 53yrs. old, female; There was edema in legs. Five months previously she had noticed abdominal extension. She was admitted to our hospital with a diagnosis of nephrotic syndrome. Predonine was administrated for one month, improving her symptoms gradually. She was discharged on the fourtieth hospital day. A few weeks after discharge abdominal extension, edema on the face developed progressively and she was readmitted to our hospital again. Laboratory examination revealed moderate proteinuria, hyperlipemia and slight decrease in renal function tests. During the hospitalization she was given predonine, imuran, decholesterol agent, diuretics and anabolic steroid, with a slight recovery of edema and proteinuria. On the 196'th hospital day she suddenly became shock state after passing the water. She gradually became stuporous. After 26 hours she expired. Autopsy revealed multiple, petechial hemorrhage with encephalomalacia in bilateral thalamus and slight membranous glomerulonephritis.
- 一般社団法人 日本血栓止血学会の論文
一般社団法人 日本血栓止血学会 | 論文
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