INTRAVENTRICULAR AND BRACHIAL-ARTERY THROMBOSIS IN NEPHROTIC SYNDROME

A 23-year-old Saudi female presented with nephrotic syndrome. On renal biopsy she had primary focal and segmental glomerulosclerosis which w as resistant to steroids. Two years later she presented with absent le ft arm pulses and on investigation a diagnosis of left ventricular thr ombosis and thromboembolism of left brachial artery was made, Low anti thrombin III, high fibrinogen levels and diuretic therapy were the pos sible causative factors for hypercoagulable state. On anticoagulation therapy initiated with heparin and continued with warfarin for 8 weeks there was complete dissolution of intraventricular and improvement of left brachial artery thrombosis. An early diagnosis and treatment of this potentially serious complication of nephrotic syndrome are stress ed.