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Direct oral anticoagulant successfully used to treat an adult nephrotic patient complicated with portal vein thrombosis

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Abstract

Thromboembolism is a major complication of nephrotic syndrome, with the renal vein being the most frequent site. However, the incidence of portal vein thrombosis (PVT) in patients with nephrotic syndrome is rare. We report a case of a relapsed steroid-dependent minimal change disease with incidental PVT. A 38-year-old man presented with anasarca. Elevated liver enzymes were discovered during routine blood testing within days after commencing treatment. Although drug-induced liver injuries are frequently observed with mild aminotransferase abnormality during therapy with steroid or immune-suppressive agents, imaging revealed a massive thrombus of the portal vein, which was treated by anticoagulant therapy with edoxaban. Treatment with anticoagulant therapy could normalize liver function. Two months after the initiation of treatment with edoxaban, the follow-up CT scan and ultrasound showed the disappearance of PVT. Our case suggests that much attention should be paid to PVT as a cause of liver enzyme elevation when treating patients with nephrotic syndrome.

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Authors and Affiliations

  1. Department of Nephrology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Tokushima, Japan

    Fumiaki Obata, Hideharu Abe, Taichi Murakami, Sayo Ueda, Taizo Inagaki, Masanori Minato, Hiroyuki Ono, Kenji Nishimura, Eriko Shibata, Masanori Tamaki, Fumi Kishi, Seiji Kishi, Kojiro Nagai & Toshio Doi

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  1. Fumiaki Obata
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  2. Hideharu Abe
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  14. Toshio Doi
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Correspondence to Hideharu Abe.

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This article contains no studies involving humans or animals.

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Informed consent was obtained from the patient whose case is reported in this study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB Approval Number 680-2) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Obata, F., Abe, H., Murakami, T. et al. Direct oral anticoagulant successfully used to treat an adult nephrotic patient complicated with portal vein thrombosis. CEN Case Rep 8, 134–138 (2019). https://doi.org/10.1007/s13730-019-00381-9

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  • DOI: https://doi.org/10.1007/s13730-019-00381-9

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