A 42 year old man presents with progressive leg swelling and foamy urine for 2 months. He has no hematuria or dysuria. Blood pressure is 146/92 mm Hg. Examination shows periorbital edema and bilateral pitting edema. Laboratory studies show serum albumin 2.1 g/dL, total cholesterol 320 mg/dL, and urinalysis with 4+ protein but no red blood cell casts. Loss of which of the following proteins most directly explains his increased risk of renal vein thrombosis?
- A)Haptoglobin
- B)Ceruloplasmin
- C)Alpha-1 antitrypsin
- D)Transferrin
- E)Antithrombin IIIGABARITO
Explicação
Nephrotic syndrome causes urinary loss of anticoagulant factors, especially antithrombin III, which produces a hypercoagulable state and predisposes to renal vein thrombosis. The vignette is classic for nephrotic syndrome because of heavy proteinuria, hypoalbu... Ver explicação completa e trilha adaptativa →