Nephrotic syndrome (NS) was first described in 1827 as the presence of proteinuria of ≥3.5 g/24 hours, albuminemia <3.0 g, peripheral edema, hyperlipidemia, lipiduria, and increased thrombotic risk. Nephrotic syndrome has an incidence of three cases per 100 000 each year in adults. Nephrotic syndrome also has serious complications due to hypercoagulable state in both various venous and arteries which could lead thromboembolic events. The pathophysiology of hypercoagulability in the nephrotic syndrome is due to an imbalance of prothrombotic and antithrombotic factors, as well as impaired thrombolytic activities.
Here we will present 19 years old women who presented to the emergency department complaining of chest pain and shortness of breath for three days. The patient was quickly diagnosed with pulmonary embolism and inferior vena cava thrombosis as a complication of nephrotic syndrome, allowing prompt initiation of anticoagulant therapy. After two weeks of admission, the patient's condition resolved, her laboratory results returned to almost normal and the patient was discharged with Oral Prednisolone, Coumadin, Atorvastatin, and Ramipril. We are aim to determine which is the likely cause of pulmonary embolism in patients with the nephrotic syndrome.