Abstract: FR-PO851
Successful Treatment of Nephrotic Syndrome due to Preeclampsia Diagnosed by Renal Biopsy
Session Information
- Women's Health and Kidney Diseases
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Women's Health and Kidney Diseases
- 2200 Women's Health and Kidney Diseases
Authors
- Kajio, Yuki, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan
- Suzuki, Hitoshi, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan
- Koshida, Takeo, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan
- Abe, Kenichiro, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan
- Kato, Arisa, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan
- Fukuda, Hiromitsu, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan
- Takahara, Hisatsugu, Juntendo Daigaku Igakubu Fuzoku Urayasu Byoin, Urayasu, Chiba, Japan
- Suzuki, Yusuke, Juntendo Daigaku Igakubu Daigakuin Igaku Kenkyuka, Bunkyo-ku, Tokyo, Japan
Introduction
Preeclampsia (PE) is the most frequent renal complication of pregnancy and is characterized by hypertension and proteinuria after 20 weeks of gestation. However, some patients with PE do not show hypertension. If the patients left untreated, PE could lead to serious complications for both the mother and baby, such as kidney function impairment, or fetal growth restriction. Thus, PE is no longer considered to be a transitory kidney disease that is cured when the baby is delivered. Moreover, the rate of pre-existing renal disease in preeclamptic women is about 70%. Focal segmental glomerulosclerosis (FSGS) is the common cause of nephrotic range proteinuria in pregnancy. It is difficult to distinguish between PE and glomerulonephritis during late pregnancy.
Case Description
A 32-year-old woman was referred for hypertension (180/108 mmHg) and massive proteinuria (13.7 g/gCr) at 34 weeks gestation. Even after delivery, massive proteinuria (7.3 g/gCr) was detected, despite well controlled blood pressure. Then, renal biopsy was performed for definitive diagnosis. Histological findings showed focal endotheliosis of the glomeruli and double contour. Immunofluorescent study showed no remarkable glomerular deposition. Reticulation of endothelial cell and duplication of GBM were detected by electron microscopy. Histological interpretation lead to definitive diagnosis as PE and to appropriate treatment, resulted in diminish of proteinuria.
Discussion
High levels of proteinuria after delivery is important index for intervention of treatment. Patients after PE has 4 times risk of hypertension, and twice risk of type 2 diabetes and dyslipidemia. Management of lifestyle-related disease after delivery is also important. In present case, histological implication lead to appropriate treatment. Therefore, histological diagnosis is important in PE patient for postpartum management.