Details

Autor(en) / Beteiligte

• Vaidyanathan, Arvind
• Trivedi, Mayuri
• Ukirde, Vivek
• Karnik, Niteen

Titel

Transfemoral thrombolysis with thrombosuction: an aid to renal biopsy in a case of acute Budd Chiari syndrome complicating nephrotic syndrome

Ist Teil von

• BMJ case reports, 2020-12, Vol.13 (12), p.e237285

Ort / Verlag

England: BMJ Publishing Group LTD

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Renal biopsy is usually a prerequisite in the diagnosis of adult patients with nephrotic syndrome. Acute Budd Chiari syndrome is a known complication of certain aetiologies of nephrotic syndrome like membranous glomerulopathy and minimal change disease. This complication requires emergent anticoagulation, which would preclude the performance of a renal biopsy. We report the case of a 47-year-old woman who presented with acute Budd Chiari syndrome as the initial presentation of nephrotic syndrome. The difficult situation in which we had to give anticoagulation and also perform a renal biopsy led us to devise a novel way to treat the patient, namely, the initial use of transfemoral thrombolysis and thrombosuction followed by a renal biopsy, which confirmed the diagnosis of primary membranous nephropathy. Anticoagulation was safely instituted 48 hours later with documented clinical and radiological improvement.