Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Intracerebral hemorrhage associated with nephrotic syndrome
-Prevalemce and clinical characteristics-

Ryuhei Kono, M.D.1)3), Hirotaka Iwaki, M.D.1)4), Shinichi Takeshima, M.D.1), Yutaka Shimoe, M.D., Ph.D.1), Shinzo Ota, M.D.2) and Masaru Kuriyama, M.D., Ph.D.1)

1)Department of Neurology, Brain Attack Center Ota Memorial Hospital
2)Department of Neurosurgery, Brain Attack Center, Ota Memorial Hospital
3)Present Address: Kin-ikyo Chuo Hospital
4)Present Address: Department of Neurology and Clinical Pharmacology, Ehime University Graduate School of Medicine

Of the 11,161 cases of stroke observed for over 9 years, 21 cases in which both levels of serum albumin and cholesterol were < 3 g/dl and > 250 mg/dl, respectively, were identified. Out of these 21 cases, cases of severe proteinuria, i.e., nephrotic syndrome were selected. These included 10 cases of arterial ischemic thrombosis, 2 cases of cerebral venous sinus thrombosis, and 4 cases of intracerebral hemorrhage. The incidence of intracerebral hemorrhage associated with nephrotic syndrome was 0.18% of total stroke or 0.036% intracerebral hemorrhage. Nephrotic syndrome essentially induced a hypercoagulable state. The 4 cases with intracerebral hemorrhage associated with nephrotic syndrome, however, had strong risk factors for intracerebral hemorrhage, suggesting that they overcame the risk for thrombophilia. The diseases associated with the nephrotic syndrome were diabetic nephropathy and amyloidosis in 3 cases and in 1 case, respectively. The nephrotic syndrome tends to be associated with a risk for venous or arterial thrombosis. In addition, we must pay attention to intracerebral hemorrhage associated with nephrotic syndrome in cases of stroke.
Full Text of this Article in Japanese PDF (507K)

(CLINICA NEUROL, 56: 180|185, 2016)
key words: intracerebral hemorrhage, nephrotic syndrome, diabetic nephropathy, thrombophilia, risk factors

(Received: 20-Oct-15)