Lower limb arterial thrombosis in an adult with membranous glomerulonephritis.

Massive proteinuria and hypoalbuminemia are potential risk factors in thromboembolic complications. Venous thrombosis is a frequent complication of thromboembolism in patients with membranous glomerulonephritis, while arterial thrombosis is much less reported. A 35-year-old man presented with nephrotic syndrome and osteofascial compartment syndrome in the right lower limb due to arterial thrombosis. The biopsy findings were consistent with those of stage 2 membranous nephropathy. After immunotherapy (steroids and cyclosporine), the massive proteinuria, renal function, and serum albumin improved markedly. This is the first case of adult membranous glomerulonephritis with unilateral lower extremity arterial thrombosis diagnosed by renal biopsy and arteriography. It further confirms the high incidence of thromboembolic complications with membranous nephropathy.