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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR  
Year : 2016  |  Volume : 27  |  Issue : 3  |  Page : 626
Remarks about the study of an unusual presentation of venous thrombosis in a child with idiopathic membranous nephropathy


Department of Pediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad, Iraq

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Date of Web Publication13-May-2016
 

How to cite this article:
Al-Mendalawi MD. Remarks about the study of an unusual presentation of venous thrombosis in a child with idiopathic membranous nephropathy. Saudi J Kidney Dis Transpl 2016;27:626

How to cite this URL:
Al-Mendalawi MD. Remarks about the study of an unusual presentation of venous thrombosis in a child with idiopathic membranous nephropathy. Saudi J Kidney Dis Transpl [serial online] 2016 [cited 2022 Jan 16];27:626. Available from: https://www.sjkdt.org/text.asp?2016/27/3/626/182448
To the Editor,

I read with interest the case report by Burri et al[1]on the unusual presentation of inferior vena cava thrombosis (IVCT) in a child with idio- pathic membranous nephropathy (MN). It is well-known that Budd-Chiari syndrome (BCS) is rare in infants and children. It results from an obstructed hepatic venous outflow tract. The obstructive lesion might be located in the main hepatic veins, in the inferior vena cava or in both. Interestingly, pediatric BCS has been increasingly reported in India.[2],[3]It is also well- known that protein C and protein S, which are vitamin K-dependent natural anticoagulants play a major role in hemostasis by degrading the activated factor V and factor VIII. Defi- ciencies of protein C and protein S are asso- ciated with increased risk of thrombotic events and could lead to the development of BCS.[4]On the other hand, among many factors, reduced levels of protein C and protein S have been implicated in the increased incidence of va- rious thromboembolic complications in neph- rotic patients.[5]I presume that BCS ought to be seriously considered in the studied patient by Burri et al[1]but unfortunately measuring serum levels of protein S and protein C was not feasible. On achieving that measurement and demonstrating their altered serum levels, I pre- sume that it would be the first report in India on IVCT-associated BCS in a pediatric patient with MN as such association is rarely reported in the literature.[6]

Conflict of interest: None declared.



 
   References Top

1.
Burri S, Yadla M, Deshpande P, et al. An unusual presentation of venous thrombosis in a child with idiopathic membranous nephropathy. Saudi J Kidney Dis Transpl 2015;26: 355-8.  Back to cited text no. 1
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2.
Misra V, Verma K, Singh DK, Misra SP. The Budd-Chiari syndrome in a child: A case report and review of the literature. J Clin Diagn Res 2012;6:1783-5.  Back to cited text no. 2
    
3.
Mehta P, Shah I, Bhatnagar S. Budd-Chiari disease in infancy: Three cases. Paediatr Int Child Health 2012;32:89-92.  Back to cited text no. 3
    
4.
Uvaraj P, Rathisharmila R, Ilamaran V. Protein C and protein S deficiency presenting as Budd- Chiari syndrome. Blood Coagul Fibrinolysis 2013;24:652-4.  Back to cited text no. 4
    
5.
Yermiahu T, Shalev H, Landau D, Dvilansky A. Protein C and protein S in pediatric nephro- tic patients. Sangre (Barc) 1996;41:155-7.  Back to cited text no. 5
    
6.
Lilova M, Velkovski IG, Velichkov NI. Budd- Chiari syndrome and inferior vena cava thrombosis in a nephrotic child. Pediatr Nephrol 2000;14:412-5.  Back to cited text no. 6
    

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Correspondence Address:
Prof. Mahmood Dhahir Al-Mendalawi
Department of Pediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad
Iraq
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DOI: 10.4103/1319-2442.182448

PMID: 27215268

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