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nephrotic syndrome in pregnancy

I N Aboobacker, A Krishnakumar, S Narayanan, B Hafeeque, J C Gopinathan, F Aziz
Nail-Patella syndrome (NPS) is an inherited disease with characteristic nail, limb, and renal anomalies. While almost all patients manifest classical skeletal and nail abnormalities, renal involvement is seen in only 40% of patients. Asymptomatic proteinuria is the most common renal presentation. Although a substantial number of patients can progress to nephrotic range proteinuria, development of end-stage kidney disease is rare. Pathological abnormalities are appreciable only by electron microscopy. Our patient who had not been diagnosed with NPS previously presented with new-onset proteinuria during the second trimester of her first pregnancy...
January 2018: Indian Journal of Nephrology
Francesca Brunini, Barbara Zaina, Davide Gianfreda, Wally Ossola, Marisa Giani, Luigi Fedele, Piergiorgio Messa, Gabriella Moroni
PURPOSE: To assess pregnancy outcome in women with Alport syndrome and the impact of pregnancy on the disease progression. METHODS: We describe one of the largest series of pregnancies in Alport syndrome. Seven pregnancies of six women were monitored by a multidisciplinary team of nephrologists and gynecologists. After delivery, patients were followed for at least 3 years. We compare our results with those in the literature. RESULTS: Pregnancy course was uneventful in the patient with isolated microscopic hematuria...
February 28, 2018: Archives of Gynecology and Obstetrics
Eiichiro Uchino, Daisuke Takada, Haruta Mogami, Takeshi Matsubara, Tatsuo Tsukamoto, Motoko Yanagita
Pregnancy and membranous nephropathy (MN) can occur concurrently with nephrotic syndrome. However, the pathophysiology of MN associated with pregnancy remains unclear, including the involvement of anti-M-type phospholipase A2 receptor (PLA2R) antibody, the major antigen of idiopathic MN (iMN). A treatment for the condition is also not established. We present the case of a 43-year-old pregnant female with incidental proteinuria and hypoalbuminemia. We made a diagnosis of nephrotic syndrome at 11 week gestation...
May 2018: CEN Case Reports
Melonie Heron
Objectives-This report presents final 2015 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 "Deaths: Final Data for 2015," the National Center for Health 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 2015...
November 2017: National Vital Statistics Reports
Hiroshi Sato, Yuna Asami, Reona Shiro, Masato Aoki, Miki Yasuda, Saeko Imai, Rie Sakai, Kenji Oida, Kanako Kawaharamura, Hiroko Yano, Nao Taguchi, Takako Suzuki, Masaya Hirose
BACKGROUND Nephrotic syndrome occurs very rarely, in only about 0.01%-0.02% of all pregnancies, and de novo minimal change disease during pregnancy is especially rare. Nephrotic syndrome and, especially, minimal change disease are highly responsive to steroids, and preterm labor may be avoidable if the maternal condition is improved with steroid therapy. Therefore, prompt diagnosis and proper management are critical to maternal and fetal outcome when severe proteinuria occurs during pregnancy. CASE REPORT A 30-year-old pregnant Japanese woman presented with systemic edema, oliguria, and severe proteinuria and hypoalbuminemia at 25 weeks of gestation, although she was normotensive...
April 18, 2017: American Journal of Case Reports
Michelle A Hladunewich, Kate Bramham, Belinda Jim, Sharon Maynard
Glomerular disease, especially lupus nephritis, is common in young women of childbearing age. As such, practicing nephrologists must have adequate knowledge and expertise to prepare these women for pregnancy, to diagnose and manage the numerous pregnancy-associated complications that are common in this vulnerable patient population and finally to support these young women who often struggle to manage both their young children along with an often onerous chronic disease. In this article we will review the pre-pregnancy counseling these women should ideally receive to allow them to make an informed decision about proceeding with a pregnancy, an approach to the diagnosis of pregnancy-associated worsening of kidney function and proteinuria as well as pregnancy-safe management strategies, including immunosuppression, antihypertensive agents and other medications necessary for the management of nephrotic syndrome...
January 1, 2017: Nephrology, Dialysis, Transplantation
Inês Martins, Madalena Gomes Conceição, Paulo Pereira Gomes, Nuno Clode
A pregnancy complicated by typical hemolytic uremic syndrome (HUS) and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome is reported. At 20 weeks of gestation, a case of HUS was diagnosed, with Shiga toxin-producing Escherichia coli identified. Plasmapheresis allowed continuation of the pregnancy for 5 weeks. Superimposed preeclampsia and HELLP syndrome were diagnosed after the establishment of nephrotic range proteinuria, hypertension and recurrence of hemolysis. This is a singular case, as it demonstrates that HELLP syndrome can superimpose upon HUS, a fact that can impact future research on reproductive immunology...
April 2017: Revista Brasileira de Ginecologia e Obstetrícia
Padmanabhan Rengasamy
Cyclophosphamide (CPA) remains one of the most widely prescribed anticancer drugs. It is also used in the treatment of rheumatoid arthritis, childhood nephrotic syndrome and systemic lupus erythematosus. It is a potent immunosuppressive agent. It is commonly used in blood and bone marrow transplantation. With the growing trend among women postponing childbearing, the number of women who are diagnosed with breast cancer is also increasing thus escalating the chances of exposure of the unborn child to antineoplastic drugs...
2017: Anti-cancer Agents in Medicinal Chemistry
Ryan Kunjal, Rabie Adam-Eldien, Raafat Makary, Francois Jo-Hoy, Charles W Heilig
We report the case of a 22-year-old African American female who presented to another facility for routine follow-up in the 34th week of pregnancy with lower extremity swelling and nephrotic-range proteinuria. Although she was normotensive, it was initially thought that she had preeclampsia. She was monitored carefully and delivery was induced at 37 weeks of gestation. She was transferred to our hospital, where she was diagnosed with systemic lupus erythematosus (SLE) based on clinical and laboratory criteria...
September 2016: Case Reports in Nephrology and Dialysis
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
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