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NEFROTİK SENDROM İLE İLİŞKİLİ BİR MASİF PULMONER EMBOLİ OLGUSU

Year 2014, Volume: 28 Issue: 2, 119 - 123, 01.10.2014

Abstract

Pulmoner tromboemboli (PTE) sık görülen, teşhisinde zorlanılan ve mortalitesi yüksek bir hastalıktır. PTE oluşumunda erken dönemde kolayca gözden kaçabilen birçok sekonder risk faktörü bulunmaktadır. Bu faktörlerden biri de nefrotik sendromdur. 24 yaşındaki erkek hasta ani başlayan nefes darlığı, göğüs ağrısı ve bayılma şikayetleri ile acil servise başvurdu. Özgeçmişinde 3 ay önce pnömoni tanısı ile tedavi gördüğü ve 2 ay önce böbrek biyopsisi ile membranöz glomerülonefrit tanısı aldığı ve tedavi olarak kortikosteroid, diüretik ve siklosporin ilaçlarını kullandığı öğrenildi. Ventilasyon / perfüzyon sintigrafisi ile pulmoner emboli tanısı konan hastaya trombolitik tedavi başlandı. Kliniği hızla düzelen hastanın yatışının 3. gününde kan gazında hipoksemisinin düzeldiği görüldü. Bir masif pulmoner emboli olgusu, nefrotik sendrom zemininde gelişmesi, trombolitik ve antikoagülan tedaviyle kısa sürede sağlığına kavuşması nedeniyle sunuldu.

References

  • 1. Ercüment E. Akciğer tromboembolisi. In: Özyardımcı N; eds. Nonspesifik akciğer hastalıkları. Cilt II. Bursa: Uludağ, 1999: 1011-25.
  • 2. Mandelli V, Schmid C, Zogno C, Morpurgo M. False negatives and false positives in acute pulmonary embolism: A clinical postmortem comparison. Cardiologia 1997; 42: 205-10.
  • 3. Morpurgo M, Schmid C, Mandelli V. Factors influencing the clinical diagnosis of pulmonary embolism: analysis of 229 postmortem cases. Int J Cardiol 1998; 65: 79-82.
  • 4. Sagripanti A, Barsotti G. Hypercoagulability, intraglomerular coagulation and thromboembolism in nephrotic syndrome. Nephron 1995; 70: 271-81.
  • 5. Li SJ, Guo JZ, Zuo K, Zhang J, Wu Y, Zhou CS, Lu GM, Liu ZH. Thromboembolic complications in membranous nephropathy patients with nephrotic syndrome-a prospective study. Thromb Res 2012; 130: 501-5.
  • 6. Park SJ, Shin J. Complicatıons of nephrotic syndrome. Korean J Pediatr 2011; 54: 322-31.
  • 7. Zdrojewski Z, Raszeja-Specht A, Skibowska A. Hypercoagulation in patients with nephrotic syndrome. Pol Merkuriusz Lek 1997; 2: 201-4 (abstract).
  • 8. Vaziri ND, Gonzales E, Barton CH, et al. Factor XIII and its substrates, fibronectin, fibrinogen, and alpha-2-antiplasmin, in plasma and urine of patients with nephrosis. J Lab Clin Med 1991; 117: 152-6.
  • 9. Cosio FG, Harker C, Batard MA, et al. Plasma concentrations of natural anticoagulants protein C and protein S in patients with proteinuria. J Lab Clin Med 1985; 106: 218-22.
  • 10. Giante A, Barbona B, Sardo L, Martina P, et al. Hipercoagulability and nephrotıc syndrome. Curr Vasc Pharmacol 2012; 22 (Epub ahead of print).
  • 11. Kuhlmann U, Blattler W, Pouliadis G, Siegenthaler W. Complications of nephrotic syndrome with special reference to thromboembolic accidents. Schweiz Med Wochenschr 1979; 109: 200-9 (abstract).
  • 12. Ikeda S, Takaya Y, Takahashi K, et al. A case of nephrotic syndrome associated with pulmonary infarction and renal vein thrombosis. (A review of literature) Nippon Jinzo Gakkai Shi 1989; 31: 883-9 (abstract).
  • 13. Kırkıl G, Tuğ T, Muz MH, Deveci F. Daha önce tanı konulmamış nefrotik sendrom zemininde gelişen pulmoner tromboemboli olgusu. Fırat Tıp Dergisi 2005; 10: 190-2.
  • 1. 14.Chen Guochun, Lıu Yinghong, Xie Yangbo et al. High dose urokinase against massıve pulmonary embolısm in neprotic syndrome. Blood Coagul Fibrinolysis. 2013; 24: 439-43.
  • 14. Pincus KJ, Hynicka LM. Prophylaxis of thromboembolic events in patients with nephrotic syndrome the annals of pharmacotherapy 2013; 47: 725-33.

A PULMONARY THROMBOEMBOLISM CASE BASED ON NEPHROTIC SYNDROME

Year 2014, Volume: 28 Issue: 2, 119 - 123, 01.10.2014

Abstract

Pulmonary thromboembolism (PTE) is a frequent disease with a high mortality and a diffucult diagnosis. There are many secondary risk factors that can be escaped notice during early stage of PTE. One of these factors is nephrotic syndrome. A 24-year-old male patient was admitted to emergency room with complaints of sudden shortness of breath and chest pain. We learned that he was treated with a diagnosis of pneumonia 3 months ago and membranous glomerulonephritis was diagnosid 2 months ago with renal biopsy. He was treated with of corticosteroids, diuretics, and cyclosporine. Thrombolytıc therapy was performed for pulmonary embolism which was diagnosed with Ventilation / perfusion scintigraphy. Here a case presenting PTE based on nephrotic syndrome is presented.

References

  • 1. Ercüment E. Akciğer tromboembolisi. In: Özyardımcı N; eds. Nonspesifik akciğer hastalıkları. Cilt II. Bursa: Uludağ, 1999: 1011-25.
  • 2. Mandelli V, Schmid C, Zogno C, Morpurgo M. False negatives and false positives in acute pulmonary embolism: A clinical postmortem comparison. Cardiologia 1997; 42: 205-10.
  • 3. Morpurgo M, Schmid C, Mandelli V. Factors influencing the clinical diagnosis of pulmonary embolism: analysis of 229 postmortem cases. Int J Cardiol 1998; 65: 79-82.
  • 4. Sagripanti A, Barsotti G. Hypercoagulability, intraglomerular coagulation and thromboembolism in nephrotic syndrome. Nephron 1995; 70: 271-81.
  • 5. Li SJ, Guo JZ, Zuo K, Zhang J, Wu Y, Zhou CS, Lu GM, Liu ZH. Thromboembolic complications in membranous nephropathy patients with nephrotic syndrome-a prospective study. Thromb Res 2012; 130: 501-5.
  • 6. Park SJ, Shin J. Complicatıons of nephrotic syndrome. Korean J Pediatr 2011; 54: 322-31.
  • 7. Zdrojewski Z, Raszeja-Specht A, Skibowska A. Hypercoagulation in patients with nephrotic syndrome. Pol Merkuriusz Lek 1997; 2: 201-4 (abstract).
  • 8. Vaziri ND, Gonzales E, Barton CH, et al. Factor XIII and its substrates, fibronectin, fibrinogen, and alpha-2-antiplasmin, in plasma and urine of patients with nephrosis. J Lab Clin Med 1991; 117: 152-6.
  • 9. Cosio FG, Harker C, Batard MA, et al. Plasma concentrations of natural anticoagulants protein C and protein S in patients with proteinuria. J Lab Clin Med 1985; 106: 218-22.
  • 10. Giante A, Barbona B, Sardo L, Martina P, et al. Hipercoagulability and nephrotıc syndrome. Curr Vasc Pharmacol 2012; 22 (Epub ahead of print).
  • 11. Kuhlmann U, Blattler W, Pouliadis G, Siegenthaler W. Complications of nephrotic syndrome with special reference to thromboembolic accidents. Schweiz Med Wochenschr 1979; 109: 200-9 (abstract).
  • 12. Ikeda S, Takaya Y, Takahashi K, et al. A case of nephrotic syndrome associated with pulmonary infarction and renal vein thrombosis. (A review of literature) Nippon Jinzo Gakkai Shi 1989; 31: 883-9 (abstract).
  • 13. Kırkıl G, Tuğ T, Muz MH, Deveci F. Daha önce tanı konulmamış nefrotik sendrom zemininde gelişen pulmoner tromboemboli olgusu. Fırat Tıp Dergisi 2005; 10: 190-2.
  • 1. 14.Chen Guochun, Lıu Yinghong, Xie Yangbo et al. High dose urokinase against massıve pulmonary embolısm in neprotic syndrome. Blood Coagul Fibrinolysis. 2013; 24: 439-43.
  • 14. Pincus KJ, Hynicka LM. Prophylaxis of thromboembolic events in patients with nephrotic syndrome the annals of pharmacotherapy 2013; 47: 725-33.
There are 15 citations in total.

Details

Other ID JA74DU98KU
Journal Section Case Report
Authors

Dursun Tatar This is me

Ceyda Anar This is me

Özlem Edipoğlu This is me

Pınar Çimen This is me

Cenk Kıraklı This is me

Publication Date October 1, 2014
Published in Issue Year 2014 Volume: 28 Issue: 2

Cite

APA Tatar, D., Anar, C., Edipoğlu, Ö., Çimen, P., et al. (2014). NEFROTİK SENDROM İLE İLİŞKİLİ BİR MASİF PULMONER EMBOLİ OLGUSU. İzmir Göğüs Hastanesi Dergisi, 28(2), 119-123.