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nephrotic syndrome in pregnancy

Emily E Fay, Kara K Hoppe, Jay Schulkin, Linda O Eckert
OBJECTIVE: The 23-valent pneumococcal vaccine is recommended for adults over 65 years of age and younger adults with certain medical conditions. The Centers for Disease Control and Prevention (CDC) state insufficient evidence to recommend routine pneumococcal vaccination during pregnancy, but the vaccine is indicated for pregnant women with certain medical conditions. We designed this project to gauge obstetrics and gynecology (OB/GYN) resident knowledge of maternal pneumococcal vaccination...
2016: Infectious Diseases in Obstetrics and Gynecology
Yoko Nishizawa, Takashi Takei, Tokiko Miyaoka, Daigo Kamei, Toshio Mochizuki, Kosaku Nitta
We describe the course of pregnancy in a 27-year-old woman with homozygous autosomal recessive Alport syndrome. Genetic analysis revealed a homozygous COL4A4 mutation in exon 36 (c.3307G > A) with p.G1102R inherited from her parents (who were parallel cousins) 1 year before conception. Before pregnancy, the patient's renal function and blood pressure were normal, and her urinary protein excretion was below 2 g/day. The pregnancy course was uneventful in the first and second trimesters. She was detected to have nephrotic-range proteinuria during the third trimester, but was observed closely on an outpatient basis without any medications, as her general condition was good, her renal function and blood pressure remained stable, and the fetal well-being was maintained...
March 2016: Journal of Obstetrics and Gynaecology Research
Christel C A van Moll, Christopher R Susanto, Petri M Kox-van Gastel
Primary hypothyroidism is a disease commonly encountered by GPs and internal medicine doctors. It is treated with levothyroxine, the synthetic T4 hormone. If a patient with primary hypothyroidism suddenly requires higher dosages the reason for this should be investigated. Common causes are drug-interactions, pregnancy or non-compliance. Nevertheless, if a patient has other symptoms such as oedema or unexpected weight gain, nephrotic syndrome should be considered. Urinalysis can be very helpful in this. Thyroxin binds to plasma albumin, high levels of which are excreted in patients with nephrotic syndrome...
2015: Nederlands Tijdschrift Voor Geneeskunde
G M Amaliev, E Uchikova, M Malinova
Pregnancy in women with chronic renal failure is a complex therapeutic problem requiring a multidisciplinary approach. It is associated with a higher risk of many perinatal complications. The most common abnormalities are related to: progression of renal failure, development of preeclampsia development of nephrotic syndrome, anemic syndrome, IUGR and fetal death. The prognosis depends on the values of serum creatinine prior to pregnancy, the degree of deterioration of renal function, development of additional obstetric complications and the specific etiological reasons that have led to the occurrence of renal failure...
2015: Akusherstvo i Ginekologii︠a︡
Patrick Hamilton, Jenny Myers, Joanna Gillham, Gwen Ayers, Nina Brown, Michael Venning
Significant proteinuria in pregnancy can indicate the presence of serious conditions requiring investigation and treatment. The nephrotic syndrome in pregnancy presents a multitude of difficulties and is a relative contraindication of renal biopsy, particularly in the third trimester. We present a case of nephrotic syndrome of unknown cause presenting at 33 weeks of pregnancy. With renal biopsy contraindicated, we used the urine protein selectivity test, a largely discarded test predicting steroid-responsive nephrotic syndrome, to help inform the decision to give steroids...
December 2014: Clinical Kidney Journal
Anne Slavotinek, Julie Kaylor, Heather Pierce, Michelle Cahr, Stephanie J DeWard, Dina Schneidman-Duhovny, Adnan Alsadah, Fadi Salem, Gabriela Schmajuk, Lakshmi Mehta
We report five fetuses and a child from three families who shared a phenotype comprising cerebral ventriculomegaly and echogenic kidneys with histopathological findings of congenital nephrosis. The presenting features were greatly elevated maternal serum alpha-fetoprotein (MSAFP) or amniotic fluid alpha-fetoprotein (AFAFP) levels or abnormalities visualized on ultrasound scan during the second trimester of pregnancy. Exome sequencing revealed deleterious sequence variants in Crumbs, Drosophila, Homolog of, 2 (CRB2) consistent with autosomal-recessive inheritance...
January 8, 2015: American Journal of Human Genetics
Melonie Heron
OBJECTIVES: This report presents final 2009 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the Division of Vital Statistics' annual report of final mortality statistics. METHODS: Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2009...
October 26, 2012: National Vital Statistics Reports
Yasushi Ohashi, Shizuka Kobayashi, Taichi Arai, Tetsuo Nemoto, Chizu Aoki, Masato Nagata, Ken Sakai
Juxtaglomerular cell tumor is a rare renal neoplasm. Secondary hypertension with juxtaglomerular cell tumor can be seen in females in their 20s and 30s. We present a case of juxtaglomerular cell tumor during pregnancy. A 32-year-old female was hospitalized for refractory hypertension and nephrotic syndrome in the 23rd gestational week. One year before admission, she had been diagnosed with hypertension; plasma renin activity at that time had been 2.3 ng/ml/h. Her blood pressure was uncontrolled during pregnancy, and proteinuria was detected in the 12th gestational week despite the administration of antihypertensive medications...
May 2014: Case Reports in Nephrology and Urology
Antonio Vukusich, Gonzalo Valls, Margarita Enberg, María José de la Piedra, Luis Contreras, Juan Carlos Bravo
Kidney biopsies were performed in two women during their 21st and 24th week of pregnancy. The first patient developed an abrupt nephrotic syndrome without hypertension or kidney failure. The pathological study disclosed diffuse podocyte alterations such as those observed in focal and segmental glomerulosclerosis, which had a good response to steroidal treatment. The second patient had a progressive renal failure associated with non-nephrotic proteinuria. The biopsy disclosed a fibrillary glomerulopathy.
August 2013: Revista Médica de Chile
Melonie Heron
OBJECTIVES: This report presents final 2010 data on the 10 leading causes of death in the United States by age, sex, race, and Hispanic origin. Leading causes of infant, neonatal, and postneonatal death are also presented. This report supplements the Division of Vital Statistics' annual report of final mortality statistics. METHODS: Data in this report are based on information from all death certificates filed in the 50 states and the District of Columbia in 2010...
December 20, 2013: National Vital Statistics Reports
Jamie O Lo, Eric Kerns, Jose Rueda, Nicole E Marshall
BACKGROUND: New onset minimal change disease (MCD) is rare in pregnancy with the potential for serious complications including acute kidney injury (AKI). CASE: A case of MCD was diagnosed at 19 weeks gestation by renal biopsy. Within one month of starting steroids, the patient experienced normalization of renal function and resolution of nephrotic syndrome, although hemodialysis was needed as a temporizing measure. CONCLUSION: The differential diagnosis for new onset proteinuria in pregnancy should include MCD...
August 2014: Journal of Maternal-fetal & Neonatal Medicine
Zaher Armaly, Suheir Assady, Zaid Abassi
PURPOSE OF REVIEW: Natriuretic peptides play a key role in regulation of blood pressure and volume homeostasis due to their natriuretic/diuretic and vasodilatory actions. The natriuretic and diuretic responses to natriuretic peptides are markedly attenuated in edematous disease states. Our goal is to review the mechanisms underlying this phenomenon, with special emphasis on the role of corin in salt retention and edema formation in heart failure and nephrotic syndrome, and pathogenesis of hypertension...
November 2013: Current Opinion in Nephrology and Hypertension
Yumie Aoshima, Masayuki Iyoda, Ai Nakazawa, Yutaka Yamaguchi, Aki Kuroki, Takanori Shibata, Tadao Akizawa
A 37-year-old woman at 17 weeks of gestation who was first noted to have proteinuria and microscopic hematuria at 13 weeks of gestation was admitted to our hospital with proteinuria that progressed to nephrotic syndrome (NS). Despite the treatment with prednisolone, including methylprednisolone pulse therapy, the NS worsened. The patient underwent an elective abortion at 21 weeks of gestation, and the NS then went into partial remission. A renal biopsy revealed membranous nephropathy (MN). There was no evidence of secondary MN...
2013: Internal Medicine
Kossi Akomola Sabi, Béfa Noto-Kadou-Kaza, Dazé Appolinaire Gnionsahe, Eyram Yoan Makafui Amekoudi, Claude Mawufemo Tsevi, Kokuvi Dzigbodi Tsonya, Dégnon Amedegnato, Koffi Gnamey
OBJECTIVE: To report the first case of congenital nephrotic syndrome of the Finnish type (SNCF) in Togo associated with a new mutation of NPHS1. OBSERVATION: Our study focused on a female infant of 10months, born premature at 34weeks 6days, followed from birth to pure SNC discovered the 10th day of life. Monitoring and pregnancy outcome unremarkable. It is the third in a family of three children, the first two are killed in a similar table but not explored before 1year of age...
December 2013: Néphrologie & Thérapeutique
Kathleen J Pincus, Lauren M Hynicka
OBJECTIVE: To review published literature regarding use of strategies to prevent thrombotic events in patients with nephrotic syndrome (NS). DATA SOURCES: The MEDLINE/PubMed, EMBASE, and Cochrane databases were queried from 1980 to December 2012 for articles in English using the search terms nephrotic syndrome, thrombosis, thromboembolism, anticoagulation, warfarin, heparin, low-molecular-weight heparin, enoxaparin, dalteparin, tinzaparin, statin, atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin, aspirin, direct thrombin inhibitor, rivaroxaban, argatroban, lepirudin, bivalirudin, dabigatran, factor Xa inhibitor, fondaparinux, rivaroxaban, clopidogrel, ticlopidine, and prasugrel...
May 2013: Annals of Pharmacotherapy
Kiran Kandukurti, Jianlan Sun, Rocco Venuto
We report a 42-year-old woman with underlying hypertension, mild renal dysfunction and proteinuria who presented as an obstetric emergency with uncontrolled hypertension and nephrotic syndrome. The rapid deterioration in her kidney function and worsening of her symptoms led to an urgent termination of her twin pregnancy. Although a clinical improvement was noticed within 10 days, the persistently elevated serum creatinine required further evaluation. A kidney biopsy showed changes consistent with acute tubular necrosis and resolving preeclampsia superimposed on focal segmental glomerulosclerosis and hypertensive kidney disease...
January 2013: Case Reports in Nephrology and Urology
José Luis Barrón Rodríguez, Francisco Piña Saucedo, Jorge Clorio Carmona, Francisco Javier Fraire González, Omar Armando Soto Ruíz
We report the case of 23 years old primingesta patient with a partial molar pregnancy 16 weeks, studying with atypical presentation of preeclampsia (high blood pressure 160/100 mmHg, proteinuria of 3.4 g in 24 hours, headache, photophobia and anasarca), so differential diagnoses ruled out (lupus nephritis, hemolytic uremic syndrome, antiphospholipid antibody syndrome, thrombotic thrombocytopenic purpura, nephrotic syndrome). Disengage vaginally were required by the presence of deterioration of maternal health with systemic repercussions...
December 2012: Ginecología y Obstetricia de México
Dusit Lumlertgul, Yuttitham Suteeka, Supaluck Tumpong, Derek Bunnachak, Suchada Boonkaew
Double filtration plasmapheresis (DFPP) was applied to the treatment of two different categories from 100 cases that had been collected over a 5 year period (2007-2011). These categories were allocated into groups by size of toxic substances, which were classified as two different kinds of diseases. Group I comprised diseases that were caused by alloimmunity in transplantation, autoimmune diseases, complicated nephrotic syndrome, pure red cell aplasia, and toxemia of pregnancy. This group was treated with a plasma separator (plasmaflow-05, Asahi Kasei) and plasma fractionators, EC-20W...
February 2013: Therapeutic Apheresis and Dialysis
Chunmei Zhao, Jijun Zhao, Yuefang Huang, Zilian Wang, Hongyue Wang, Hui Zhang, Hanshi Xu, Niansheng Yang
Few studies have been published focusing on the clinical features of new-onset systemic lupus erythematosus (SLE) during pregnancy. This study examined the clinical characteristics of SLE during pregnancy or puerperium. The clinical characteristics and serological parameters of 48 patients with onset of SLE during pregnancy were retrospectively compared with those of age-matched new-onset SLE patients who were diagnosed in a period of more than 12 months without pregnancy (n = 65) and age-matched preeclampsia patients (n = 48)...
June 2013: Clinical Rheumatology
Emmanuel Spaggiari, Marie Ruas, Sophie Dreux, Anne-Sylvie Valat, Isabelle Czerkiewicz, Fabien Guimiot, Thomas Schmitz, Anne-Lise Delezoide, Françoise Muller
OBJECTIVE: To assess maternal-fetal outcomes in pregnancies associated with persistently elevated second-trimester maternal serum alpha-fetoprotein. STUDY DESIGN: A retrospective cohort study in 658 patients with maternal serum alpha-fetoprotein ≥2.5 multiple of median, performed at routine Down syndrome screening. Maternal serum alpha-fetoprotein was assayed a second time in 341 of them. Outcomes were recorded in all cases. RESULTS: The group with unexplained maternal serum alpha-fetoprotein persistently ≥2...
April 2013: American Journal of Obstetrics and Gynecology
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