Analysis of 10 Pediatric Nephrotic Syndrome Cases With Complications of Cerebral Sinovenous Thrombosis

Frontiers in Pediatrics

article

Liping Rong¹  Lizhi Chen¹  Zhi Dong²  Hongjie Zhuang¹  Zhilang Lin¹  Ying Mo¹  Xiaoyun Jiang¹ 

[1] Department of Pediatrics, The Children Kidney Center, First Affiliated Hospital, Sun Yat-sen University;Department of Radiology, First Affiliated Hospital, Sun Yat-sen University

关键词: cerebral sinovenous thrombosis;    children;    nephrotic syndrome;    magnetic resonance venography (MRV);    complication;   

DOI  :  10.3389/fped.2020.607776

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: To analyze the clinical characteristics of nephrotic syndrome (NS) with complications of cerebral sinovenous thrombosis (CSVT) in children. Method: Clinical, radiographic, laboratory, and treatment data obtained from 10 confirmed cases of NS with complications of CSVT were analyzed. All patients were followed up for at least 18 months. CSVT was diagnosed by cerebral computed tomography (CT) and/or magnetic resonance imaging (MRI) with or without magnetic resonance venography (MRV) of the cerebral vessels. Results: Among 10 cases reported, 4 were steroid-sensitive NS with frequent relapse, 5 were steroid-resistant (three of them had renal biopsies showing two minimal change disease and one IgA nephropathy), and 1 was steroid-sensitive with one relapse. Common clinical manifestations were headache or ophthalmodynia complicated by vomiting, dizziness, convulsion, and coma. Neuropathologic signs were positive in some cases. Papilledema appeared in only one case with winding of vein. Cerebrospinal fluid was examined in three cases with elevated pressure but normal cytological and biochemical results. D dimer and fibrinogen levels were elevated while prothrombin time and activated partial thromboplastin time were shortened. Five out of seven cases who had performed cranial CT were suspicious for cerebral thrombosis. Nine cases had cranial MRI with abnormal signs in seven cases. All of the cases received MRV, confirming the diagnosis of CVST. Conclusion: Clinical manifestations of NS with CSVT are not specific but varied. Therefore, CSVT should be considered once nervous manifestations present. MRV is a better method in the diagnosis of CSVT.

【 授权许可】

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