Korean J Med.  2015 Feb;88(2):212-217. 10.3904/kjm.2015.88.2.212.

A Case of Acute Pancreatitis: Portal Vein Superimposed Thrombosis in a Nephritic Syndrome Patient

• Kim NM
• Yoo JH
• Sung WK
• Yun SA
• Jeong JU
• Shin JH
• Bang KT

• KMID: 2269155
• DOI: http://doi.org/10.3904/kjm.2015.88.2.212

Abstract

Nephrotic syndrome is characterized by hypercoagulability and thrombosis of the renal and deep veins. We describe a case of unusual thrombosis in the portal and superior mesenteric veins of a 41-year-old female, admitted for treatment of abdominal pain, who simultaneously presented with nephrotic syndrome and acute pancreatitis. Laboratory analysis revealed hypoalbuminemia, hyperlipidemia, and proteinuria. Abdominal computed tomography revealed acute pancreatitis, thrombosis at the portal and superior mesenteric veins, and ischemic changes in the colon and small intestines. Anticoagulation therapy was started immediately. Abdominal pain was subsequently reduced and the ischemic lesion disappeared. Warfarin use could not be terminated immediately. Empirical steroid therapy commenced without a kidney biopsy. Complete remission occurred after 4 weeks. Following warfarin cessation, a kidney biopsy was performed, confirming the diagnosis of minimal change disease.

Keyword

Nephrotic syndrome; Pancreatitis

MeSH Terms

Abdominal Pain
Adult
Biopsy
Colon
Diagnosis
Female
Humans
Hyperlipidemias
Hypoalbuminemia
Intestine, Small
Kidney
Mesenteric Veins
Nephrosis, Lipoid
Nephrotic Syndrome
Pancreatitis*
Portal Vein*
Proteinuria
Thrombophilia
Thrombosis*
Veins
Warfarin
Warfarin