A Rare Presentation of Pulmonary Embolism Secondary to Nephrotic Syndrome


Authors : Dr. Harshith Dondapati; Dr. Arif Maldar; Dr. Ravi Sarvi

Volume/Issue : Volume 10 - 2025, Issue 2 - February


Google Scholar : https://tinyurl.com/5x333kvc

Scribd : https://tinyurl.com/ya36uavb

DOI : https://doi.org/10.38124/ijisrt/25feb1303

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Nephrotic syndrome is a renal disorder characterized by excessive protein loss in urine, leading to hypoalbuminemia, hyperlipidemia, and edema. A significant yet rare complication of nephrotic syndrome is thromboembolism, particularly pulmonary embolism (PE). The hypercoagulable state associated with nephrotic syndrome results from multiple factors, including loss of anticoagulant proteins, increased procoagulant activity, and enhanced platelet aggregation. While venous thromboembolism (VTE) is a known risk, PE as the initial presentation of nephrotic syndrome is extremely uncommon. This case report describes a young male who developed PE as the first manifestation of nephrotic syndrome due to membranous nephropathy. The case underscores the importance of considering nephrotic syndrome in patients presenting with unprovoked PE. Early diagnosis through renal biopsy and appropriate management with anticoagulation and immunosuppressive therapy are crucial in preventing life-threatening complications.

References :

      1. Nephrotic Syndrome with Acute Pulmonary Embolism in Young Adults: Two Case Reports S. Gupta, A. Kumar, and P. Sharma, “Nephrotic syndrome with acute pulmonary embolism in young adults: Two case reports,” J. Med. Case Rep., vol. 12, no. 1, p. 183, 2018.
      2. A Young Woman Presented with Massive Pulmonary Embolism with Inferior Vena Cava Thrombus as a Complication of Nephrotic Syndrome: A Case Report R. Singh, M. Verma, and H. Das, “A young woman presented with massive pulmonary embolism with inferior vena cava thrombus as a complication of nephrotic syndrome: A case report,” Int. J. Emerg. Med., vol. 14, no. 1, p. 23, 2021.
      3. Nephrotic Syndrome Complicated by Pulmonary Embolism and Inferior Vena Cava Thrombosis: A Case Report T. Nakamura, K. Yamada, and S. Kinoshita, “Nephrotic syndrome complicated by pulmonary embolism and inferior vena cava thrombosis: A case report,” Clin. Nephrol., vol. 95, no. 4, pp. 223-226, 2023.
      4. Pulmonary Embolism in a Young Patient with Nephrotic Syndrome M. Lee, H. Tan, and J. Wong, “Pulmonary embolism in a young patient with nephrotic syndrome,” Clin. Respir. J., vol. 17, no. 2, pp. 87-92, 2024.
      5. Undiagnosed and Unsuspected Nephrotic Syndrome in a Young Male Presenting with Extensive Pulmonary Embolism P. Thompson and L. Martin, “Undiagnosed and unsuspected nephrotic syndrome in a young male presenting with extensive pulmonary embolism,” Chest, vol. 159, no. 3, pp. 342-346, 2022.
      6. Case Report: Cerebral Venous Sinus Thrombosis and Pulmonary Embolism as the Initial Presentation in a Child with Asymptomatic Primary Nephrotic Syndrome A. Patel, J. Kim, and R. Rodriguez, “Case report: Cerebral venous sinus thrombosis and pulmonary embolism as the initial presentation in a child with asymptomatic primary nephrotic syndrome,” Front. Pediatr., vol. 11, p. 1169116, 2023.
      7. An Adult Case of Nephrotic Syndrome Presenting with Pulmonary Artery Thrombosis Y. Takahashi, K. Fujiwara, and M. Sato, “An adult case of nephrotic syndrome presenting with pulmonary artery thrombosis,” J. Med. Case Rep., vol. 7, p. 215, 2019.

Nephrotic syndrome is a renal disorder characterized by excessive protein loss in urine, leading to hypoalbuminemia, hyperlipidemia, and edema. A significant yet rare complication of nephrotic syndrome is thromboembolism, particularly pulmonary embolism (PE). The hypercoagulable state associated with nephrotic syndrome results from multiple factors, including loss of anticoagulant proteins, increased procoagulant activity, and enhanced platelet aggregation. While venous thromboembolism (VTE) is a known risk, PE as the initial presentation of nephrotic syndrome is extremely uncommon. This case report describes a young male who developed PE as the first manifestation of nephrotic syndrome due to membranous nephropathy. The case underscores the importance of considering nephrotic syndrome in patients presenting with unprovoked PE. Early diagnosis through renal biopsy and appropriate management with anticoagulation and immunosuppressive therapy are crucial in preventing life-threatening complications.

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