Korean J Med.  1998 Nov;55(5):946-950.

A case of myocardial infarction in the minimal change nephrotic syndrome

• Song SH
• Lee WC
• Park SM
• Seoug EY
• Ann JH
• Lee DW
• Lee SB
• Jung HC
• Kwak IS
• Rha HY

Abstract

The authors report the case of a 25 year old woman with a chronic corticosteroid-refractory nephrotic syndrome complicated by myocardial infarction. The thromboembolism, especially acute myocardial infarction, is the most serious complication of nephrotic syndrome. Until now many mechanisms have been studied about thromboem bolism including coronary artery disease in nephrotic syndrome, but not clear. Hypercoagulability and prolonged hyperlipidemia are known as the principal contributing factors in this complication. In addition, use of steroid as therapeutic trial and hypovolemic state induced by vigorous diuretics will affect the thromboembolism, too. In this case, several coagulation abnormality and prolonged hyperlipidemia are observed. On admission day, this patient had deep vein thrombosis and then was complicated by pulmonary thromboembolism. Despite of anticoagulant and thrombolytic therapy, she experienced acute myocardial infarction on fourth day after admission. After onset of myocardial infarction, by thrombolytics and prolonged anticoagulant therapy, this nephrotic patient was relieved and discharged without other serious complication. We recommend anticoagulant and antiplatelet agent therpy in risky patient of nephrotic syndrome. We present this case with review of literature.

Keyword

minimal change nephrotic syndrome; myocardial infarction; deep vein thrombosis; pulmonary embolism

MeSH Terms

Adult
Coronary Artery Disease
Diuretics
Female
Humans
Hyperlipidemias
Hypovolemia
Myocardial Infarction*
Nephrosis, Lipoid*
Nephrotic Syndrome
Pulmonary Embolism
Thromboembolism
Thrombolytic Therapy
Thrombophilia
Venous Thrombosis
Diuretics