# A Case of Pulmonary Thromboembolism in a Child With Steroid-Resistant Nephrotic Syndrome

## TL;DR

A child with a kidney disease had a dangerous blood clot in her lungs, showing the need for careful monitoring and quick treatment.

## Contribution

This case emphasizes the risk of blood clots in children with steroid-resistant nephrotic syndrome and the importance of timely diagnosis and treatment.

## Key findings

- A child with steroid-resistant nephrotic syndrome developed a life-threatening pulmonary thromboembolism.
- Prompt anticoagulation treatment with heparin and enoxaparin was initiated following diagnosis.
- The case highlights the hypercoagulable state in SRNS and the need for vigilance in managing complications.

## Abstract

A seven-year-old girl with steroid-resistant nephrotic syndrome (SRNS) presented to the Emergency Department with chest pain, palpitations, dyspnea, and generalized edema. She had been receiving immunosuppressants but remained nephrotic. During evaluation, she was found to have an acute occlusive pulmonary thromboembolism (PTE), confirmed by CT pulmonary angiography. Anticoagulation was initiated promptly with heparin, followed by enoxaparin, a low-molecular-weight, long-acting heparin.

This case highlights the increased risk of thromboembolic events in children with SRNS due to their hypercoagulable state. It underscores the importance of vigilant SRNS management, awareness of life-threatening complications, such as pulmonary embolism (PE), timely imaging, and prompt treatment.