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Case series of thromboembolic complications in childhood nephrotic syndrome: Hacettepe experience

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Abstract

Background

The aim of this study was to describe the incidence and contributory risk factors for thromboembolic complications in children with nephrotic syndrome (NS) and thrombosis.

Methods

Among 188 children with the diagnosis of NS (80 girls; mean age: 12.6 ± 5.4 years) followed up in our hospital for the last 5 years, 17 (9.0 %) children (16 boys) identified as having thromboembolic complications. All 17 children with NS and thrombosis were screened for laboratory risk factors for thrombosis. The diagnosis was confirmed by cranial magnetic resonance imaging, doppler ultrasonography, and echocardiography.

Results

Among 17 children with thrombosis, 14 (82.3 %) were found to have focal segmental glomerulosclerosis (FSGS) as underlying pathology by renal biopsy. The mean age of the thrombotic children was 4.5 ± 3.2 years at the diagnosis of NS and that was 7.1 ± 4.9 years at the time of thrombosis. The mean time from NS diagnosis to the first thrombosis development was 2.6 ± 2.3 years. Thrombosis occurred during the first year of NS in 9/17 (52.9 %) children. Most of the children (88.2 %) had venous thrombosis. Among the screened risk factors, high factor VIII level (64.7 %) was the leading factor followed by decreased antithrombin III level (29.4 %). Furthermore, 4 children had central venous catheters and 2 had infection as clinical risk factors for thrombosis.

Conclusion

In this case series, subtype of FSGS, active disease state of NS, central venous catheters, and some inherited and acquired thrombotic risk factors have been identified as contributory factors for the development of thrombosis in children with NS.

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Conflict of interest

The authors have declared that no conflict of interest exists.

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Authors and Affiliations

  1. Pediatric Hematology Unit, Hacettepe Univesity Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey

    Betul Tavil, Selin Aytac, Sule Unal, Baris Kuskonmaz, Mualla Cetin & Fatma Gumruk

  2. Pediatric Nephrology Unit, Hacettepe Univesity Faculty of Medicine, Sihhiye, 06100, Ankara, Turkey

    Fehime Kara, Rezan Topaloglu & Nesrin Besbas

Authors
  1. Betul Tavil
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  2. Fehime Kara
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  3. Rezan Topaloglu
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  4. Selin Aytac
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  5. Sule Unal
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  6. Baris Kuskonmaz
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  7. Mualla Cetin
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  8. Nesrin Besbas
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  9. Fatma Gumruk
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Correspondence to Rezan Topaloglu.

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Tavil, B., Kara, F., Topaloglu, R. et al. Case series of thromboembolic complications in childhood nephrotic syndrome: Hacettepe experience. Clin Exp Nephrol 19, 506–513 (2015). https://doi.org/10.1007/s10157-014-1005-y

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  • DOI: https://doi.org/10.1007/s10157-014-1005-y

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