Patient with relapsed minimal change disease presenting with bilateral lower extremity arterial thrombosis after COVID-19 infection: a case report

Minimal change disease (MCD) is a common cause of nephrotic syndrome, and thrombosis is a well-known complication of nephrotic syndrome. We report a case of acute thrombosis follow-ing COVID-19 infection in a 61-year-old woman diagnosed with MCD 11 years ago and was in complete remission (CR). She was infected with COVID-19 and developed swelling and pain in both legs three weeks later. Laboratory results suggested relapse of MCD, and imaging study found thrombosis in right common iliac artery, external iliac artery, internal iliac artery, and deep femoral artery. With emergent intervention and medication, the thrombosis resolved, and MCD achieved CR. In this case, the patient was at a high risk of thrombosis because both MCD and COVID-19 infection are known to increase the risk of thrombosis. The possibility of a thrombotic event in nephrotic syndrome should always be considered, especially if other conditions, such as COVID-19 infection, are combined.