Pulmonary Thrombosis Unmasking an Underlying Membranous Nephropathy

CASE REPORT, August 2015, VOL IV ISSUE I, ISSN 2042-4884
10.5083/ejcm.20424884.138 , Cite or Link Using DOI
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Dr. Kunal Gandhi MBBS MD, Dr. Dharmendra Prasad MBBS MD, Dr. Vinay Malhotra MBBS MD DM, Dr. Pankaj Beniwal MBBS MD DM & Dr. Dhananjai Agrawal MBBS MD DM

ABSTRACT

Thromboembolism is a frequent complication of nephrotic syndrome. Pulmonary embolism secondary to deep vein thrombosis or renal vein thrombosis is described in the literature. However, isolated pulmonary thrombosis as the first presentation of nephrotic syndrome is rarely reported. Herein, we report a case of a 26 year old male who presented with persistent chest pain and dyspnea, initially misdiagnosed as a lower respiratory tract infection, only to be diagnosed later with pulmonary arterial thrombosis. Workup for a hypercoagulable state revealed a nephrotic range proteinuria and hyperlipidemia. Renal biopsy was suggestive of secondary membranous nephropathy. He had an elevated thyroid stimulating antibody levels with positive antiperoxidase antibodies. He was initiated on oral thyroxine and anticoagulation. Considering the often fatal nature of pulmonary thromboembolism, early recognition of this entity complicating nephrotic syndrome is essential.