ICNC Abstracts, ICNC 2018

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A RARE COMPLICATION OF NEPHROTIC SYNDROME IN PEDIATRICS - ISCHEMIC STROKE
NEHA MANJHANI, SAKSHI SHARMA, RAVI SHARMA, RAJIV BANSAL, VIVEK JAIN

Last modified: 2018-09-09

Abstract


INTRODUCTION:Patients with nephrotic syndrome (NS) are prone to thrombo-embolic phenomena. Acute ischemic stroke is a rare complication of NS & not widely reported in the literature. We report this case to illustrate the importance of considering hypercoagulability from NS as a potential cause of embolic stroke & to initiate anticoagulation treatment. CASE REPORT: A 10year girl presented with headache for 15 days followed by sudden onset left sided weakness during 3rd relapse of NS. She was diagnosed with NS 1 year back .Medication history at the time of presentation included tablet prednisolone since 10 days of 3rd relapse. Her vitals were stable with facial puffiness. Neurologic exam showed UMN left facial weakness & left sided weakness. Laboratory tests showed proteinuria & hypercoagulable workup was normal. Renal vein & femoral vein Doppler were normal.MRI brain showed Diffusion restriction in right fronto-parietal region & basal ganglia suggestive of Right MCA territory. CTvenoangiogram brain showed thrombus in Right ICA with normal venogram. Given the  ischemic  infarcts, NS was considered likely etiology ,anticoagulation initiated patient & weakness improved. DISCUSSION: In this case of acute embolic stroke in the setting of NS with a normal coagulation profile & cardiac workup. As the likelihood of hypercoagulability secondary to NS was high, started  on anticoagulation. Arterial thrombosis is rare & more common in the pediatric patient but described in the femoral arteries commonly not in cerebral vasculature. CONCLUSION: In patients with ischemic stroke with concomitant nephrotic syndrome, anticoagulation for the secondary prevention of stroke should be considered.

Keywords


nephrotic syndrome, ischemic stroke,anticoagulation,angiography

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