The differential diagnosis between preeclamptic toxemia and glomerulonephritis in patients with proteinuria during pregnancy.
The renal biopsies from 123 patients who presented with proteinuria during pregnancy have been reviewed. Forty-seven showed glomerulonephritis that could be diagnosed on morphological grounds or on a clear-cut history of urine abnormalities before pregnancy. Fifty of the remaining 76 had been followed after pregnancy. In these 50 patients, a retrospective diagnosis of glomerulonephritis or preeclamptic toxemia was based on the persistence or disappearance of proteinuria and/or hematuria three or more months after pregnancy. Among 22 in whom a biopsy diagnosis of "pure" preeclamptic toxemia had been made, 19 showed disappearance of urine abnormalities after pregnancy, thus confirming the biopsy diagnosis. A retrospective analysis showed focal and segmental glomeris group but none in the preeclamptic toxemia group. Other differences could not be defined without quantitative evaluation; however, the glomeruli appeared to be more cellular in the glomerulonephritis group. The presence of IgA, IgG, IgM, Complement, and fibrin was not of value in distinguishing glomerulonephritis from preeclamptic toxemia.
D001158:Arteries / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005921:Glomerulonephritis / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000473:pathology; D011225:Pre-Eclampsia / Q000150:complications; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000473:pathology; D011507:Proteinuria / Q000209:etiology*