A Case of Pulmonary Thromboembolism in a Child With Steroid-Resistant Nephrotic Syndrome

A seven-year-old girl with steroid-resistant nephrotic syndrome (SRNS) presented to the Emergency Department with chest pain, palpitations, dyspnea, and generalized edema. She had been receiving immunosuppressants but remained nephrotic. During evaluation, she was found to have an acute occlusive pulmonary thromboembolism (PTE), confirmed by CT pulmonary angiography. Anticoagulation was initiated promptly with heparin, followed by enoxaparin, a low-molecular-weight, long-acting heparin. This case highlights the increased risk of thromboembolic events in children with SRNS due to their hypercoagulable state. It underscores the importance of vigilant SRNS management, awareness of life-threatening complications, such as pulmonary embolism (PE), timely imaging, and prompt treatment.