Tromboembolismo pulmonar no síndrome nefrótico associado a trombofilia

introduction: children with nephrotic syndrome (ns) have an increased risk of thromboembolic complications. case report: the authors report a case of 12 year-old boy with steroid resistant nephrotic syndrome, treated with prednisone, cyclosporine, omeprazole, enalapril and acetylsalicylic acid. he was admitted for anasarca and poor renal perfusion, with initial good response to daily albumin infusions. by the fourth day of hospitalization he presented fever, chest pain, hemoptysis and worsening of dyspnea. computed tomography pulmonary angiography showed central and peripheral acute pulmonary thromboembolism, with multiple areas of pulmonary infarction and pleural effusion of small volume. screening for hereditary thrombophilia showed heterozygosity for the g20210a mutation in prothrombin gene and homozygosity for the thermolabile variant c677t of the methylenetetrahydrofolate reductase. conclusion: the thromboembolic complications in children with ns are rare and its diagnosis requires a high index of suspicion. screening for inherited thrombophilia is important to identify patients with ns and increased thrombotic risk.