Recurrent renal vein thrombosis consequent to membranous glomerulonephritis

The diagnosis by inferior vena cavography of right renal vein thrombosis with extension into the vena cava was made in a 33 year old man with idiopathic membranous glomerulonephritis and multiple pulmonary emboli. After one year of continuous anticoagulant drug therapy with heparin and coumadin, venography showed absence of clots in the vena cava and therapy was discontinued. Proteinuria in excess of 4 g/24 hr continued. Six months later pulmonary emboli recurred and venography again demonstrated large clots in the vena cava and right renal vein. The potential for recurrence of renal vein thrombosis and pulmopnary embolism in the presence of active renal diseases is thus demonstrated.