Vascular Complications in Nephrotic Syndrome: Relationship to Steroid Therapy and Accelerated Thromboplastin Generation

Abstract

Arterial thrombosis and renal vein thrombosis occurred in two men and one woman, respectively, treated with steroids for the nephrotic syndrome. Raised serum cholesterol occurred in one patient only. Though bleeding, clotting, and prothrombin times, as well as the platelet counts, were normal, the rate of thromboplastin generation was increased in all three patients. Adding heparin to the plasma of one patient slowed the rate, and suggested that the raised rate could be due to removal or suppression of such normal circulating coagulation inhibitors. The thromboplastin generation test seems to be useful in diagnosing and managing such hypercoagulable states, and may help in further investigations of their causes.