Bilateral renal infarctions and lower limbs artery thrombosis in a patient with nephrotic syndrome

Thromboembolism is a well-recognized complication in patients with nephrotic syndrome owing to their hypercoagulable status. Usually, the venous system is affected, whereas the very rare occurrence of arterial thrombosis is mainly restricted to pediatric patients. This complication often results in high rates of mortality and limb loss. We report the case of an adult female patient with histologically diagnosed minimal change disease and nephrotic syndrome associated with malignant thymoma, who eventually developed concurrent bilateral kidney and lower limb thrombosis. Conservative systemic anticoagulation was administered and she recovered ample kidney function. In addition, although she underwent an emergent thrombectomy of the left popliteal artery, an amputation was necessary. To the best of our knowledge, this is the first reported arterial thrombosis case involving bilateral kidney and lower limb simultaneously in nephrotic patients. Our experience indicates that arterial thrombosis is a serious complication in nephrotic patients, and early detection and aggressive management are crucial in these patients to improve their outcome.