Nasrin Hoseiny Nejad1, Amin Sadat Sharif2, Hasan Otukesh3, Rozita Hosseini Shamsabadi3, Sepideh Hekmat4, Maryam Sakhaei5. 1. Aliasghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran. 2. Pediatric Department, Kashan University of Medical Sciences, Kashan, Iran. Sharifdr4@gmail.com. 3. Department of Pediatric Nephrology, Iran University of Medical Sciences, Tehran, Iran. 4. Department of Nuclear Medicine, School of Medicine, Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran. 5. Department of Pediatric Intensive Care Unit (PICU), Iran University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND: Thromboembolism is one of the most important and dangerous complications of nephrotic syndrome. This study aimed to determine the value of albumin, anti-thrombin III, fibrinogen and D-dimer factors in the prediction of asymptomatic pulmonary embolism in patients with nephrotic syndrome in non-remission period. METHODS: Plasma levels of albumin, anti-thrombin III, fibrinogen and D-dimer were assessed in 30 nephrotic children in non-remission period (including new case-patient or relapse period), and the results were compared with chest X-ray and lung perfusion scintigraphy (Q scan). RESULTS: The mean age of patients was 6.22 ± 3.5 years (range 2-12 years). Of patients, 23.3% had abnormal findings in perfusion scan suggestive of pulmonary emboli despite absence of any respiratory manifestations. Median plasma albumin and anti-thrombin III levels in patients with asymptomatic pulmonary embolism were lower than in patients without pulmonary embolism. Also, median fibrinogen and D-dimer levels in patients with asymptomatic pulmonary embolism were higher than in patients without pulmonary embolism, with no statistically significant differences between sex, age, hemoglobin and hematocrit of patients and lung perfusion scan results. CONCLUSION: Patients with abnormal blood levels of albumin (< 3.5 g/dl), anti-thrombin III (< 80 ml/dl), fibrinogen (> 400 ml/dl) and D-dimer (> 0.5 μg/dl) underwent CXR/Q scan and were treated with heparin if there was pulmonary embolism.
BACKGROUND: Thromboembolism is one of the most important and dangerous complications of nephrotic syndrome. This study aimed to determine the value of albumin, anti-thrombin III, fibrinogen and D-dimer factors in the prediction of asymptomatic pulmonary embolism in patients with nephrotic syndrome in non-remission period. METHODS: Plasma levels of albumin, anti-thrombin III, fibrinogen and D-dimer were assessed in 30 nephrotic children in non-remission period (including new case-patient or relapse period), and the results were compared with chest X-ray and lung perfusion scintigraphy (Q scan). RESULTS: The mean age of patients was 6.22 ± 3.5 years (range 2-12 years). Of patients, 23.3% had abnormal findings in perfusion scan suggestive of pulmonary emboli despite absence of any respiratory manifestations. Median plasma albumin and anti-thrombin III levels in patients with asymptomatic pulmonary embolism were lower than in patients without pulmonary embolism. Also, median fibrinogen and D-dimer levels in patients with asymptomatic pulmonary embolism were higher than in patients without pulmonary embolism, with no statistically significant differences between sex, age, hemoglobin and hematocrit of patients and lung perfusion scan results. CONCLUSION: Patients with abnormal blood levels of albumin (< 3.5 g/dl), anti-thrombin III (< 80 ml/dl), fibrinogen (> 400 ml/dl) and D-dimer (> 0.5 μg/dl) underwent CXR/Q scan and were treated with heparin if there was pulmonary embolism.
Authors: Long Jiang Zhang; Zhuoli Zhang; Shi Jun Li; Felix G Meinel; John W Nance; Chang Sheng Zhou; Yan E Zhao; U Joseph Schoepf; Guang Ming Lu Journal: Radiology Date: 2014-07-28 Impact factor: 11.105
Authors: Alberto Zagury; Anne Louise de Oliveira; Jose Augusto Araujo Montalvão; Regina Helena Leite Novaes; Vinicius Martins de Sá; Carlos Augusto Pinheiro de Moraes; Marcelo de Sousa Tavares Journal: J Bras Nefrol Date: 2013 Jul-Sep