SHM Converge Scientific Abstract ePoster Gallery-Atypical Presentation of Pulmonary Embolism in Nephrotic Syndrome: An Overlooked Complication

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Nephrotic syndrome (NS) is defined by proteinuria, hypoalbuminemia, hyperlipidemia, and edema. It creates a hypercoagulable state because of urinary loss of proteins, increased fibrinogen and clotting factors, and systemic inflammation, which raises the risk of venous thromboembolism, including pulmonary embolism (PE). PE is a serious and potentially fatal complication of NS and should be considered even when a patient’s overall risk seems low.<br /><br />This case highlights how PE can be overlooked in NS because symptoms may be nonspecific or even absent. Reported rates of asymptomatic PE in NS range from 12% to 30%. In this young patient, the initial symptoms were thought to be due to pneumonia, but the presence of tachycardia, hypoxemia, hypoalbuminemia, and the underlying hypercoagulable state prompted evaluation for PE, leading to the diagnosis.<br /><br />The report emphasizes that PE in NS may be underrecognized because of atypical presentations and limited published cases. As a result, diagnosis can be delayed or missed. Although there are no formal guidelines for preventing venous thromboembolism in NS, studies suggest thrombosis risk increases significantly when albumin levels fall below about 2.8 g/dL.<br /><br />Overall, the key message is that clinicians should maintain a high index of suspicion for PE in patients with nephrotic syndrome, especially when hypoalbuminemia is present, because prompt diagnosis and treatment are critical to reducing morbidity and mortality.

Asset Subtitle

Klarissa A. Saldivar

Meta Tag

Author List Devkarn Sandhu, Klarissa A. Saldivar

Category Clinical Vignettes

Concept Nephrotic Syndrome

Concept Proteinuria

Concept Hypoalbuminemia

Concept Hypercoagulable State

Concept Pulmonary Embolism

Distinguished Non-Finalist

Presenter Organization University of the Incarnate Word

Presenting Author Klarissa A. Saldivar

Track Adult

Keywords

nephrotic syndrome

pulmonary embolism

hypercoagulable state

proteinuria

hypoalbuminemia

venous thromboembolism

edema

tachycardia

hypoxemia

thrombosis risk

Nephrotic Syndrome

Proteinuria

Hypoalbuminemia

Hypercoagulable State

Pulmonary Embolism