Coagulopathy and spontaneous hemorrhage in a patient with nephrotic syndrome.
Clin Nephrol
; 84(1): 55-60, 2015 Jul.
Article
en En
| MEDLINE
| ID: mdl-26104187
ABSTRACT
Patients with nephrotic syndrome, particularly those with membranous nephropathy tend to be in a hypercoagulable state and often present with thromboembolic phenomena. The association of nephrotic syndrome with a bleeding diathesis however is much less common and the etiologies less well recognized. We report a patient who presented with coagulopathy and recurrent spontaneous hemorrhage in association with nephrotic syndrome. The case highlights key diagnostic and therapeutic challenges and strategies 1) work up to establish a unifying etiology for both nephrotic syndrome and the bleeding disorder; 2) decision making to obtain a tissue biopsy, select the site of biopsy and understand the relative yields for each site; 3) recognizing the risk and managing peri-procedural bleeding; and 5) developing a treatment strategy with the lowest risk of possible complications. Our patient underwent a kidney biopsy without any complications and a definitive diagnosis of AL amyloidosis was reached. He was treated with anti-plasma cell chemotherapy followed by autologous stem cell transplant with resultant complete hematologic response, improved coagulation parameters, and no further bleeding.
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Bases de datos:
MEDLINE
Asunto principal:
Trastornos de la Coagulación Sanguínea
/
Hemorragia
/
Síndrome Nefrótico
Tipo de estudio:
Prognostic_studies
Límite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
Clin Nephrol
Año:
2015
Tipo del documento:
Article
País de afiliación:
Estados Unidos