[Nephrotic syndrome complicated with intracranial venous thrombosis treated with urokinase: report of 5 cases].

ABSTRACT

OBJECTIVE: To explore the effect of urokinase and low molecular weight heparin in children with nephrotic syndrome complicated with intracranial venous thrombosis. METHODS: Urokinase and low molecular weight heparin were administered to the 5 patients intravenously. The initial dose of urokinase was 2000 - 4000 U/(kg.d), the initial pulse dose was 20 000 - 40 000 U given within 15 - 30 minutes, and the left was infused by using a pump, from the second day 2000 U/(kg.d) urokinase was infused daily for 3 to 7 days. During the treatment thrombin time (TT), activated partial thromboplastin time (APTT) were tested 3 times every week, with particular attention to bleeding. Low molecular weight heparin 100 - 120 AXaIU/kg, 1 or 2 times per day was hypodermally injected for a course of two weeks. Anti-platelet drugs long-term oral administration of dipyridamole 3 - 5 mg/(kg.d) was applied 2 - 3 times every day for 3 months. RESULTS: The clinical symptoms disappeared after one month of the combined therapy of urokinase, low molecular weight heparin and dipyridamole in 5 cases of nephrotic syndrome complicated with intracranial venous thrombosis in children, the plasma viscosity returned to normal in 1 month, activated partial thromboplastin time, prothrombin time, fibrinogen degradation products returned to normal in 1 to 2 months, venous thrombosis disappeared after 1 to 3 months in head CT or MRI examination, showing the cerebral venous sinus thrombosis complete recanalization without relapse cases in follow-up. CONCLUSION: The early application of urokinase and low molecular heparin and anti-platelet coagulation drugs was effective. The early diagnosis, treatment and prevention of intracranial vein thrombosis in patients with nephrotic syndrome is important.