Acute dural venous sinus thrombosis in a child with idiopathic steroid-dependent nephrotic syndrome: a case report
Nephrotic syndrome (NS) is a hypercoagulable state in which children are at risk of venous thromboembolism. A higher risk has been reported in children with steroid-resistant NS than in those with steroid-sensitive NS. The mortality rate of cerebral venous sinus thrombosis (CVST) is approximately 10...
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| Format: | Article |
| Language: | English |
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Korean Society of Pediatric Nephrology
2022-12-01
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| Series: | Childhood Kidney Diseases |
| Subjects: | |
| Online Access: | http://chikd.org/upload/pdf/ckd-22-041.pdf |
| _version_ | 1811161528340054016 |
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| author | Se Jin Park Haing-Woon Baik Myung Hyun Cho Ju Hyung Kang |
| author_facet | Se Jin Park Haing-Woon Baik Myung Hyun Cho Ju Hyung Kang |
| author_sort | Se Jin Park |
| collection | DOAJ |
| description | Nephrotic syndrome (NS) is a hypercoagulable state in which children are at risk of venous thromboembolism. A higher risk has been reported in children with steroid-resistant NS than in those with steroid-sensitive NS. The mortality rate of cerebral venous sinus thrombosis (CVST) is approximately 10% and generally results from cerebral herniation in the acute phase and an underlying disorder in the chronic phase. Our patient initially manifested as a child with massive proteinuria and generalized edema. He was treated with albumin replacement and diuretics, angiotensin-converting enzyme inhibitor, and deflazacort. Non-contrast computed tomography showed areas of hyperattenuation in the superior sagittal sinus when he complained of severe headache and vomiting. Subsequent magnetic resonance imaging revealed empty delta signs in the superior sagittal, lateral transverse, and sigmoid sinuses, suggesting acute CVST. Immediate anticoagulation therapy was started with unfractionated heparin, antithrombin III replacement, and continuous antiproteinuric treatment. The current report describes a life-threatening CVST in a child with steroid-dependent NS, initially diagnosed by contrast non-enhanced computed tomography and subsequently confirmed by contrast-enhanced magnetic resonance imaging, followed by magnetic resonance venography for recanalization, addressing successful treatment. |
| first_indexed | 2024-04-10T06:16:55Z |
| format | Article |
| id | doaj.art-0b6f6faffe7e43528374487dfed504d6 |
| institution | Directory Open Access Journal |
| issn | 2384-0242 2384-0250 |
| language | English |
| last_indexed | 2024-04-10T06:16:55Z |
| publishDate | 2022-12-01 |
| publisher | Korean Society of Pediatric Nephrology |
| record_format | Article |
| series | Childhood Kidney Diseases |
| spelling | doaj.art-0b6f6faffe7e43528374487dfed504d62023-03-02T06:33:50ZengKorean Society of Pediatric NephrologyChildhood Kidney Diseases2384-02422384-02502022-12-0126210110610.3339/ckd.22.041777Acute dural venous sinus thrombosis in a child with idiopathic steroid-dependent nephrotic syndrome: a case reportSe Jin Park0Haing-Woon Baik1Myung Hyun Cho2Ju Hyung Kang3 Department of Pediatrics, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Republic of Korea Department of Biochemistry, Eulji University School of Medicine, Daejeon, Republic of Korea Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea Department of Pediatrics, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Republic of KoreaNephrotic syndrome (NS) is a hypercoagulable state in which children are at risk of venous thromboembolism. A higher risk has been reported in children with steroid-resistant NS than in those with steroid-sensitive NS. The mortality rate of cerebral venous sinus thrombosis (CVST) is approximately 10% and generally results from cerebral herniation in the acute phase and an underlying disorder in the chronic phase. Our patient initially manifested as a child with massive proteinuria and generalized edema. He was treated with albumin replacement and diuretics, angiotensin-converting enzyme inhibitor, and deflazacort. Non-contrast computed tomography showed areas of hyperattenuation in the superior sagittal sinus when he complained of severe headache and vomiting. Subsequent magnetic resonance imaging revealed empty delta signs in the superior sagittal, lateral transverse, and sigmoid sinuses, suggesting acute CVST. Immediate anticoagulation therapy was started with unfractionated heparin, antithrombin III replacement, and continuous antiproteinuric treatment. The current report describes a life-threatening CVST in a child with steroid-dependent NS, initially diagnosed by contrast non-enhanced computed tomography and subsequently confirmed by contrast-enhanced magnetic resonance imaging, followed by magnetic resonance venography for recanalization, addressing successful treatment.http://chikd.org/upload/pdf/ckd-22-041.pdfanticoagulantscase reportsmagnetic resonance angiographynephrotic syndromethrombosis |
| spellingShingle | Se Jin Park Haing-Woon Baik Myung Hyun Cho Ju Hyung Kang Acute dural venous sinus thrombosis in a child with idiopathic steroid-dependent nephrotic syndrome: a case report Childhood Kidney Diseases anticoagulants case reports magnetic resonance angiography nephrotic syndrome thrombosis |
| title | Acute dural venous sinus thrombosis in a child with idiopathic steroid-dependent nephrotic syndrome: a case report |
| title_full | Acute dural venous sinus thrombosis in a child with idiopathic steroid-dependent nephrotic syndrome: a case report |
| title_fullStr | Acute dural venous sinus thrombosis in a child with idiopathic steroid-dependent nephrotic syndrome: a case report |
| title_full_unstemmed | Acute dural venous sinus thrombosis in a child with idiopathic steroid-dependent nephrotic syndrome: a case report |
| title_short | Acute dural venous sinus thrombosis in a child with idiopathic steroid-dependent nephrotic syndrome: a case report |
| title_sort | acute dural venous sinus thrombosis in a child with idiopathic steroid dependent nephrotic syndrome a case report |
| topic | anticoagulants case reports magnetic resonance angiography nephrotic syndrome thrombosis |
| url | http://chikd.org/upload/pdf/ckd-22-041.pdf |
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