Multiple Arterial Thrombosis in Nephrotic Syndrome: Clinical Nephrology Case Report

Background: Isolated arterial thrombosis is rare, with incidence of less than 1.8% to 5% in adults. Here, we present a case of an adult with isolated multiple arterial thrombosis, which preceded the diagnosis of nephrotic syndrome (due to C3 glomerulonephritis)–A rare presentation. Case summary: 29-year-old male presented with nephrotic syndrome with renal failure. He had history of multiple partial arterial thrombosis involving the le t renal artery, superior and inferior mesenteric arteries, and femoral arteries without venous involvement, two months prior to his current presentation. The pro-cogulant work up, including APLA, was negative, but he was not screened for nephrotic syndrome at that time. He improved with heparin infusion and did not require thrombolysis or any interventional procedures. Renal biopsy done at current admission revealed C3 glomerulonephritis con irmed by electron microscopy. Genetic study revealed a deletion in the CFHR3 gene on Chromosome 1. Multiplex Ligation-dependent Probe Ampli ication (MLPA) revealed a heterozygous deletion of CFHR1/CFHR3 genes, with a dosage coe icient of 0.4. Despite treatment, the patient progressed to end-stage renal disease. Conclusion: Without evidence of concomitant TMA in renal biopsy, the association between C3GN and isolated arterial thrombosis hasn’t been established in literature. This case has been presented in view of rarity in presentation.

Author(s): G Prasanna Babu*, Edwin Fernando M, Thirumalvalavan S and Thirumalvalavan K

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