Fulminant cerebral infarctions with membranous nephropathy.

BACKGROUND

Arterial thromboses, including cerebral infarction, are a rare complication of the nephrotic syndrome.

SUMMARY OF REPORT: A 37-year-old woman presented with right upper extremity ischemia, left middle cerebral artery thrombosis, and right cerebellar infarction. She quickly herniated, and postmortem evaluation revealed membranous nephropathy. Increased fibrinogen and decreased free protein S levels were noted.

CONCLUSIONS

Membranous nephropathy can lead to rapidly progressive cerebral infarctions, with possible fatality. There is not a unifying hematologic explanation for the strokes seen with nephrotic syndrome.