Clinical features and prognosis in patients with nephrotic syndrome complicated with cerebral venous sinus thrombosis / 中国脑血管病杂志

ABSTRACT

Objective: To investigate the clinical features and prognosis in patients with nephrotic syndrome (NS) complicated with cerebral venous sinus thrombosis (CVST). Methods: The clinical data of 14 patients with NS complicated with CVST admitted in the departments of neurology and nephrology, Jinling Hospital, Nanjing, China from January 2007 to January 2011 were analyzed retrospectively. The clinical manifestations, imaging, laboratory tests, therapeutic management and follow-up results of the patients were analyzed. Results: Circled digit oneThe age range of the patients was 13-62 years old (mean age, 31 ± 16). Their main clinical manifestations were headache, vomiting, motor dysfunction, and seizures. Circled digit twoCT/MRI/MRV suggested that the positive ratio of CVST was 13/14. Under the circumstances of failing to diagnose by MRI, 1 patient was diagnosed by DSA. The sites of lesion were mainly in the superior sagittal sinus, followed by the transverse sinus. Circled digit threeSerum albumin of 12 patients was less than 25 g/L, and plasma fibrinogen of 8 patients was higher than 4 g/L. Circled digit four14 patients were followed up for 12-60 months (mean 29 ± 14 months). Head MRI/MRV was reexamined in 8 patients, 6 of them showed recanalization of originally occluded vein or venous sinus. Clinical cure were happened in 13 patients (mRS 0); only 1 patient had headache (mRS 1). There was no recurrence of CVST found. Conclusion: If the patients with NS experience headache, motor dysfunction, and seizures, neuroimaging examination should be performed timely in order to identify whether it is CVST or not. Early diagnosis and early anticoagulant therapy may have a good outcome for patients complicated with CVST.