Letal hypertrombotisk tilstand ved nefrotisk syndrom

A twenty-year old woman was admitted to hospital with impaired consciousness and a left hemiparesis. A cerebral CAT-scanning was reported normal. Convulsions and respiratory insufficiency made intubation and mechanical ventilation necessary. Laboratory examination showed an extremely low concentration of albumin in plasma (109 microM) and gross albuminuria was present. No other signs of renal failure occurred. The patient deteriorated during three days and died with signs of cerebral incarceration, despite efforts to reduce intracranial pressure. Autopsy showed a large thrombus of the sagittal sinus as the presumed cause of death. No thrombus was found in the renal vein. The association between nephrotic syndrome and thrombosis is discussed.