Chronic inferior venacava thrombosis in membranous nephropathy.

A 30-year-old gentleman, a known membranous nephropathy patient since 2002, presented a month ago for recurrent bipedal oedema and dilated veins in front and back of abdomen (Figure 1). After contrast prophylaxis, a venogram was done with the intention of intervention in the same sitting if required. His venogram showed non-visualization of the entire infra-hepatic inferior venacava (IVC) that was replaced by collaterals with reformation of the supra-hepatic segment of the IVC (Figure 2). He was treated with placement of an IVC filter and anticoagulation. Patients with nephrotic syndrome have an increased incidence (10–40%) of arterial and venous thrombosis particularly of the deep veins and renal veins. A variety of haemostatic abnormalities contribute to the hypercoagulable state including loss of antithrombin, hyperaggregablity