Limits...
Management of Membranous Glomerulonephritis in Pregnancy: A Multidisciplinary Challenge.

Ope-Adenuga S, Moretti M, Lakhi N - Case Rep Obstet Gynecol (2015)

Bottom Line: However, after the early first trimester, she developed nephrotic range proteinuria, hypoalbuminemia, and peripheral edema.After delivery of the baby, all clinical symptoms rapidly resolved and laboratory values normalized.We review the clinical course, diagnosis, and management of new onset nephrotic syndrome in pregnancy.

View Article: PubMed Central - PubMed

Affiliation: Richmond University Medical Center, Department of Obstetrics and Gynecology, 355 Bard Avenue, Staten Island, NY 10301, USA.

ABSTRACT
We present a case of 28-year-old female, who had a past obstetrical history complicated by uncontrolled blood pressure, early onset preeclampsia, and a fetal demise at 29 weeks. Her blood pressure normalized after each pregnancy, and no diagnosis of renal disease was ever established. In her most recent pregnancy, she remained normotensive and initially presented with normal blood urea nitrogen and creatinine levels. However, after the early first trimester, she developed nephrotic range proteinuria, hypoalbuminemia, and peripheral edema. After delivery of the baby, all clinical symptoms rapidly resolved and laboratory values normalized. We review the clinical course, diagnosis, and management of new onset nephrotic syndrome in pregnancy.

No MeSH data available.


Related in: MedlinePlus

Light microscopy with thickened capillary loops.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4697080&req=5

fig2: Light microscopy with thickened capillary loops.

Mentions: Renal biopsy was done at 25 weeks. On light microscopy (Figure 2), the glomeruli were enlarged, and 3/17 glomeruli were globally sclerosed. The mesangium showed an increase in cellularity. There was no endocapillary proliferation, crescents, or fibrinoid necrosis present. The capillary loops were thickened and showed spikes on sliver methenamine stain. The tubules showed focal signs of acute tubular injury with vacuolation, blebbing, dilatation, and nuclear dropout. There was not vasculitis or vascular necrosis present. PLA2R was negative. On direct immunofluorescence (Figure 3) there was granular staining in capillary loops for IgG (2+), IgA (1+), IgM (trace), C3 (trace), C1q (trace), kappa (1+), lambda (2+), and fibrinogen (trace). There was no significant glomerular staining for albumin, nor significant staining in the tubular basement membrane or vessel walls. Electron microscopy (Figure 4) revealed global thickening of the glomerular basement membrane due to subepithelial and intramembranous immune type electron dense deposits. There were no subendothelial or mesangial immune type deposits noted.


Management of Membranous Glomerulonephritis in Pregnancy: A Multidisciplinary Challenge.

Ope-Adenuga S, Moretti M, Lakhi N - Case Rep Obstet Gynecol (2015)

Light microscopy with thickened capillary loops.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4697080&req=5

fig2: Light microscopy with thickened capillary loops.
Mentions: Renal biopsy was done at 25 weeks. On light microscopy (Figure 2), the glomeruli were enlarged, and 3/17 glomeruli were globally sclerosed. The mesangium showed an increase in cellularity. There was no endocapillary proliferation, crescents, or fibrinoid necrosis present. The capillary loops were thickened and showed spikes on sliver methenamine stain. The tubules showed focal signs of acute tubular injury with vacuolation, blebbing, dilatation, and nuclear dropout. There was not vasculitis or vascular necrosis present. PLA2R was negative. On direct immunofluorescence (Figure 3) there was granular staining in capillary loops for IgG (2+), IgA (1+), IgM (trace), C3 (trace), C1q (trace), kappa (1+), lambda (2+), and fibrinogen (trace). There was no significant glomerular staining for albumin, nor significant staining in the tubular basement membrane or vessel walls. Electron microscopy (Figure 4) revealed global thickening of the glomerular basement membrane due to subepithelial and intramembranous immune type electron dense deposits. There were no subendothelial or mesangial immune type deposits noted.

Bottom Line: However, after the early first trimester, she developed nephrotic range proteinuria, hypoalbuminemia, and peripheral edema.After delivery of the baby, all clinical symptoms rapidly resolved and laboratory values normalized.We review the clinical course, diagnosis, and management of new onset nephrotic syndrome in pregnancy.

View Article: PubMed Central - PubMed

Affiliation: Richmond University Medical Center, Department of Obstetrics and Gynecology, 355 Bard Avenue, Staten Island, NY 10301, USA.

ABSTRACT
We present a case of 28-year-old female, who had a past obstetrical history complicated by uncontrolled blood pressure, early onset preeclampsia, and a fetal demise at 29 weeks. Her blood pressure normalized after each pregnancy, and no diagnosis of renal disease was ever established. In her most recent pregnancy, she remained normotensive and initially presented with normal blood urea nitrogen and creatinine levels. However, after the early first trimester, she developed nephrotic range proteinuria, hypoalbuminemia, and peripheral edema. After delivery of the baby, all clinical symptoms rapidly resolved and laboratory values normalized. We review the clinical course, diagnosis, and management of new onset nephrotic syndrome in pregnancy.

No MeSH data available.


Related in: MedlinePlus