Pulmonary Embolism in a Young Patient with Nephrotic Syndrome: A Case Report

Nephrotic syndrome (NS) is characterized by the presence of proteinuria of ≥ 3,5 g/24 h, hypoalbuminemia < 2.5 g/dl, peripheral edema, and severe hyperlipidaemia. NS is associated with increased risk of deep venous thrombosis (DVT), and, consequently, pulmonary embolism (PE). We report a case of a severe PE in a young patient with NS, admitted to the Emergency Medicine Department of the University Hospital Sant’Andrea of Rome. The aim of this report is to allow a more comprehensive knowledge of the NS and its related PE highlighting both the risk of underdiagnosis and the need of a multidisciplinary approach by a team of different specialists. We also reviewed pathophysiology of hypercoagulability in NS characterized by the imbalance of prothrombotic and antithrombotic factors, and by impaired thrombolytic activities. A more complete knowledge of the clinical and laboratory features of NS and its related PE appears to be crucial for the early diagnosis and treatment.