A 52-year-old man with biopsy-proven membranous nephropathy and nephrotic syndrome develops sudden left flank pain and gross haematuria. Left leg swelling appears over hours. Doppler ultrasound shows an echogenic filling defect extending into the left renal vein. Which glomerular disorder carries the highest association with this complication?
- A IgA nephropathy
- B Minimal change disease
- C Membranous nephropathy ✓
- D Post-infectious glomerulonephritis
Correct answer: C. Membranous nephropathy
Explanation
Membranous nephropathy has the strongest association with renal vein thrombosis among the glomerulopathies because antithrombin III and other small regulatory proteins are lost in urine along with albumin, creating a prothrombotic state superimposed on dense immune deposits. Thrombosis may be silent or present with flank pain, haematuria, and a rise in proteinuria, as described here. Minimal change disease causes nephrotic syndrome but thrombosis rates are far lower, and the other two options are nephritic rather than strongly prothrombotic disorders.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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