. . . . "[F7FCE71D4A2C]" . "Masivn\u00ED plicn\u00ED embolie jako prvn\u00ED p\u0159\u00EDznak nefrotick\u00E9ho syndromu u 18let\u00E9 pacientky"@cs . "1" . "68" . "Massive pulmonary embolism as a first symptom of nephrotic syndrome in 18-years old female patient"@en . . "Star\u00E1, Veronika" . "0069-2328" . "Masivn\u00ED plicn\u00ED embolie jako prvn\u00ED p\u0159\u00EDznak nefrotick\u00E9ho syndromu u 18let\u00E9 pacientky" . "CZ - \u010Cesk\u00E1 republika" . "The incidence of thromboembolic complications (TEC) in patients with nephrotic syndrome (NS) is about 1.8-5%, but may be underestimated. Most patients with TEC are asymptomatic. We report a case of an 18-years old female patient on hormonal contraception with irrelevant family and personal history presenting a clinical picture of dyspnea, chest pain, collapse and discrete edemas of eyelids, arms and legs. On echocardiography were indirect signs of pulmonary hypertension, dilation and dysfunction of right ventricle, on ECG was right bundle branch block. At this point, CT-angiography was performed and confirmed the bilateral massive pulmonary embolism (PE). Anticoagulation therapy with heparin and subsequently low-molecular heparin was started. Ultrasound examination focused on detection of the source of embolism was negative, as well the clinical symptoms of previous deep vein thrombosis. Further examinations proved nephrotic proteinuria (6 g/m2/day), biochemical parameters corresponded to NS. Renal biopsy proved the diagnosis of minimal change NS. Therapy with prednisone was started according to standard protocol with transient effect on proteinuria, during withdrawal of corticosteroids the proteinuria increased again. After that, immunosuppressive therapy with cyclosporine A was initiated. The NS should be considered in differential diagnoses in patients with PE, all these patients should undergo urine testing for proteinuria. As we demonstrate, massive PE can be rarely the first symptom of NS."@en . . . . "86445" . "Zieg, Jakub" . "http://www.prolekare.cz/cesko-slovenska-pediatrie-clanek/masivni-plicni-embolie-jako-prvni-priznak-nefrotickeho-syndromu-u-18lete-pacientky-39978" . "Charv\u00E1t, Ji\u0159\u00ED" . . "6"^^ . . . . "7"^^ . . "Hor\u00E1\u010Dkov\u00E1, Miroslava" . . "RIV/00064203:_____/13:10193610" . "7"^^ . "Masivn\u00ED plicn\u00ED embolie jako prvn\u00ED p\u0159\u00EDznak nefrotick\u00E9ho syndromu u 18let\u00E9 pacientky"@cs . "I" . "\u010Ceskoslovensk\u00E1 pediatrie" . . . "Incidence tromboembolick\u00FDch komplikac\u00ED u pacient\u016F s nefrotick\u00FDm syndromem (NS) je ud\u00E1v\u00E1na kolem 1,8-5 %, m\u016F\u017Ee v\u0161ak b\u00FDt podhodnocena. V\u011Bt\u0161ina pacient\u016F s tromboembolickou nemoc\u00ED (TEN) je asymptomatick\u00E1. Osmn\u00E1ctilet\u00E1 pacientka u\u017E\u00EDvaj\u00EDc\u00ED hormon\u00E1ln\u00ED antikoncepci s nev\u00FDznamnou rodinnou a osobn\u00ED anamn\u00E9zou byla p\u0159ijata pro du\u0161nost, bolest na hrudi, kolapsov\u00FD stav a diskr\u00E9tn\u00ED otoky v\u00ED\u010Dek, rukou a nohou. Echokardiografick\u00E9 vy\u0161et\u0159en\u00ED prok\u00E1zalo nep\u0159\u00EDm\u00E9 zn\u00E1mky plicn\u00ED hypertenze, dilataci a dysfunkci prav\u00E9 komory, na EKG byl blok prav\u00E9ho Tawarova ram\u00E9nka. CT vy\u0161et\u0159en\u00ED potvrdilo oboustrannou masivn\u00ED plicn\u00ED embolii (PE). Byla zah\u00E1jena antikoagula\u010Dn\u00ED terapie heparinem, kter\u00E1 byla n\u00E1sledn\u011B p\u0159evedena na n\u00EDzkomolekul\u00E1rn\u00ED heparin. Ultrazvukov\u00E9 vy\u0161et\u0159en\u00ED neprok\u00E1zalo zdroj embolizace, stejn\u011B tak nebyly p\u0159\u00EDtomny ani symptomy hlubok\u00E9 \u017Eiln\u00ED tromb\u00F3zy. Dal\u0161\u00ED podrobn\u011Bj\u0161\u00ED vy\u0161et\u0159en\u00ED odhalila v\u00FDraznou nefrotickou proteinurii (6 g/m2/den), biochemick\u00E9 parametry odpov\u00EDdaly NS. Proveden\u00E1 ren\u00E1ln\u00ED biopsie prok\u00E1zala diagn\u00F3zu nefrotick\u00E9ho syndromu s minim\u00E1ln\u00EDmi zm\u011Bnami glomerul\u016F. Terapie prednisonem podle standardn\u00EDho protokolu m\u011Bla pouze p\u0159echodn\u00FD efekt, p\u0159i vysazov\u00E1n\u00ED do\u0161lo k op\u011Btovn\u00E9mu vzestupu proteinurie. N\u00E1sledn\u011B byla zah\u00E1jena terapie cyklosporinem A. Nefrotick\u00FD syndrom by m\u011Bl b\u00FDt diferenci\u00E1ln\u011B diagnosticky zva\u017Eov\u00E1n u v\u0161ech pacient\u016F s PE, v\u0161ichni tito pacienti by m\u011Bli podstoupit vy\u0161et\u0159en\u00ED mo\u010Di na proteinurii. Jak jsme demonstrovali, masivn\u00ED plicn\u00ED embolie m\u016F\u017Ee b\u00FDt vz\u00E1cn\u011B prvn\u00EDm symptomem NS."@cs . "RIV/00064203:_____/13:10193610!RIV14-MZ0-00064203" . . . "Masivn\u00ED plicn\u00ED embolie jako prvn\u00ED p\u0159\u00EDznak nefrotick\u00E9ho syndromu u 18let\u00E9 pacientky" . . "Fencl, Filip" . . . "Bl\u00E1hov\u00E1, Kv\u011Bta" . "Incidence tromboembolick\u00FDch komplikac\u00ED u pacient\u016F s nefrotick\u00FDm syndromem (NS) je ud\u00E1v\u00E1na kolem 1,8-5 %, m\u016F\u017Ee v\u0161ak b\u00FDt podhodnocena. V\u011Bt\u0161ina pacient\u016F s tromboembolickou nemoc\u00ED (TEN) je asymptomatick\u00E1. Osmn\u00E1ctilet\u00E1 pacientka u\u017E\u00EDvaj\u00EDc\u00ED hormon\u00E1ln\u00ED antikoncepci s nev\u00FDznamnou rodinnou a osobn\u00ED anamn\u00E9zou byla p\u0159ijata pro du\u0161nost, bolest na hrudi, kolapsov\u00FD stav a diskr\u00E9tn\u00ED otoky v\u00ED\u010Dek, rukou a nohou. Echokardiografick\u00E9 vy\u0161et\u0159en\u00ED prok\u00E1zalo nep\u0159\u00EDm\u00E9 zn\u00E1mky plicn\u00ED hypertenze, dilataci a dysfunkci prav\u00E9 komory, na EKG byl blok prav\u00E9ho Tawarova ram\u00E9nka. CT vy\u0161et\u0159en\u00ED potvrdilo oboustrannou masivn\u00ED plicn\u00ED embolii (PE). Byla zah\u00E1jena antikoagula\u010Dn\u00ED terapie heparinem, kter\u00E1 byla n\u00E1sledn\u011B p\u0159evedena na n\u00EDzkomolekul\u00E1rn\u00ED heparin. Ultrazvukov\u00E9 vy\u0161et\u0159en\u00ED neprok\u00E1zalo zdroj embolizace, stejn\u011B tak nebyly p\u0159\u00EDtomny ani symptomy hlubok\u00E9 \u017Eiln\u00ED tromb\u00F3zy. Dal\u0161\u00ED podrobn\u011Bj\u0161\u00ED vy\u0161et\u0159en\u00ED odhalila v\u00FDraznou nefrotickou proteinurii (6 g/m2/den), biochemick\u00E9 parametry odpov\u00EDdaly NS. Proveden\u00E1 ren\u00E1ln\u00ED biopsie prok\u00E1zala diagn\u00F3zu nefrotick\u00E9ho syndromu s minim\u00E1ln\u00EDmi zm\u011Bnami glomerul\u016F. Terapie prednisonem podle standardn\u00EDho protokolu m\u011Bla pouze p\u0159echodn\u00FD efekt, p\u0159i vysazov\u00E1n\u00ED do\u0161lo k op\u011Btovn\u00E9mu vzestupu proteinurie. N\u00E1sledn\u011B byla zah\u00E1jena terapie cyklosporinem A. Nefrotick\u00FD syndrom by m\u011Bl b\u00FDt diferenci\u00E1ln\u011B diagnosticky zva\u017Eov\u00E1n u v\u0161ech pacient\u016F s PE, v\u0161ichni tito pacienti by m\u011Bli podstoupit vy\u0161et\u0159en\u00ED mo\u010Di na proteinurii. Jak jsme demonstrovali, masivn\u00ED plicn\u00ED embolie m\u016F\u017Ee b\u00FDt vz\u00E1cn\u011B prvn\u00EDm symptomem NS." . . "minimal change disease; nephrotic syndrome; pulmonary embolism; proteinuria"@en . "Massive pulmonary embolism as a first symptom of nephrotic syndrome in 18-years old female patient"@en . "Peckov\u00E1, Marie" .