Vol. 5, Issue 1, Part B (2019)

Nephrotic syndrome (NS) is a renal disorder characterized by heavy proteinuria, hypoalbuminemia, edema, and hypercholesterolemia. The reported annual incidence of nephrotic syndrome is between two and seven per 100 000 children aged 1 to 18 years.

Children with NS are at risk for venous and arterial thrombosis, uncommon but serious complications of the nephrotic syndrome. Multiple factors contribute to the hypercoagulable state in nephrotic children. The reported incidence of thromboembolic complications in nephrotic children is relatively high, ranging from 1.8% to 5.3%.

We a report a previously healthy boy who was diagnosed idiopathic nephrotic syndrome at six years of age who developed sudden onset of convergent strabismus of his right eye without deterioration of his sensorium. A Magnetic Resonance (MR) scan of the brain with venography was performed, and which revealed:- Posterior segment of superior sagittal sinus right transverse and sigmoid sinuses, right internal jugular vein shows loss of flow void on all pulse sequences along with absence of flow signal suggestive of dural venous sinus thrombosis.

Conclusion: Children with nephrotic syndrome are at risk of thromboembolic complications including CSVT. The present case report highlights the importance of having a high index of suspicion for cerebral sinovenous thrombosis in cases of nephrotic syndrome with any neurological symptoms. If available, MRI coupled with MRV is the imaging modality of choice. Early recognition, immediate anticoagulation therapy, and control of nephrotic syndrome are essential measures to ensure a good prognosis.