Nephrotic Syndrome may rarely present as Acute lower extremity arterial thrombosis

A recent study has uncovered a rare but serious complication in adults with nephrotic syndrome (NS) - acute lower extremity arterial thrombosis. The study aims to draw attention to these unusual cases, emphasizing early recognition and proper management to prevent misdiagnosis and delayed treatment. This study was published in BMC Nephrology by Xinqiang Han and colleagues.

The study analyzed patients with nephrotic syndrome and arterial thrombosis from January 2011 to October 2022. The study focused on adult cases, revealing the unique nature of this complication in adult patients with nephrotic syndrome. In addition to analyzing their own cases, the researchers conducted a review of existing literature to provide a comprehensive overview of the issue.

Nephrotic syndrome is known for its hypercoagulable state, leading to thromboembolic complications. Venous thrombosis is more common, but arterial thrombosis, although rarer, is a more severe manifestation. In this study, nine adults with nephrotic syndrome and acute lower extremity arterial thrombosis were analyzed. The main findings are as follows:

• Clinical Presentations: Seven of the nine patients had fresh arterial thrombi that preceded the diagnosis of nephrotic syndrome, highlighting the need for awareness of this association. Two patients had thrombosis limited to the popliteal artery.
  
• Treatment Outcomes: Among the seven patients with fresh thrombi, three required above-knee amputations, while four underwent arterial revascularization, resulting in satisfactory lower-extremity perfusion. The two patients with isolated popliteal artery thrombosis received successful anticoagulant treatment.
  
• Importance of Early Recognition: This study emphasizes the importance of early recognition and appropriate management of acute lower extremity arterial thrombosis in patients with nephrotic syndrome to achieve favorable patient outcomes.
  

Healthcare providers should be aware of the potential for acute lower extremity arterial thrombosis in adult patients with nephrotic syndrome. Early diagnosis and prompt intervention, whether through amputation or arterial revascularization, can greatly impact patient outcomes.

Reference:

Han, X., Zhao, P., Wang, Z., Ji, X., & Zhao, M. Acute lower extremity arterial thrombosis associated with nephrotic syndrome in adults: case series and literature review. BMC Nephrology,2023;24(1). https://doi.org/10.1186/s12882-023-03374-0