Bilateral Renal-vein Thrombosis and the Nephrotic Syndrome in Adults

Abstract

In both, of these 2 fatal cases the symptoms referable to the nephrotic state began insidiously and progressed despite the usual therapeutic measures. The renal problem was complicated by pulmonary-artery thrombotic occlusions. Necropsy demonstrated renal enlargement, membranous changes in the glomerular capillary tufts, and a granular deposit in the glomerular basement-membrane region. In one case, a renal biopsy employing the electron microscope showed fusion of the epithelial foot processes and an electron-dense deposit between the fused processes and the glomerular basement membrane. Review was made of 36 other published cases involving adults. If the diagnosis of the nephrotic syndrome in association with thrombosis of the renal veins can be established by angiographic studies and renal biopsy, anticoagulant therapy or thrombectomy or both may be of benefit.