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NDT Advance Access originally published online on June 16, 2009
Nephrology Dialysis Transplantation 2009 24(10):3240-3243; doi:10.1093/ndt/gfp283
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Hypercoagulability in a patient with chronic chyluria, proteinuria and hypoalbuminaemia

Ladan Golestaneh1, Sabine Karam1, Janis Lawrence2, Sara Yang1 and Mark Greenberg1

1 Department of Medicine, Montefiore Medical Center 2 Department of Medicine, Jacobi Medical Center, Bronx, NY, USA

Correspondence and offprint requests to: Ladan Golestaneh; E-mail: lgolesta{at}montefiore.org



  Abstract

We describe the case of a young man with prolonged and severe chyluria from a previous parasitic infection. He presented with an acute myocardial infarction most likely secondary to increased clotting tendency. He had a spontaneously formed blood clot in his left anterior descending coronary artery. In the setting of hypo-albuminemia (which has occurred because of obligate losses of protein from lymphuria), he has increased production of factor VIII levels and increased clotting tendency. In addition, because of obligate and unregulated fluid losses he has chronic dehydration, miscrovascular ischemia and secondary polycythemia. This polycythemia further increases his risk of hypercoagulability.

Keywords: chyluria; hypercoagulable; hypoalbuminaemia; polycythaemia

Received for publication: 28. 4.09
Accepted in revised form: 20. 5.09


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