FSGS-like lesions in pre-eclampsia.
Renal-biopsy specimens taken from pre-eclamptic patients are associated sometimes with focal-segmental glomerular sclerotic lesions (FSGS-like lesions) that closely resemble those of primary focal-segmental glomerulosclerosis. We studied a series of 60 sections from each of 19 cases of "pure" pre-eclampsia by light microscopy. Group I comprised 13 patients with FSGS-like lesions in their glomeruli, group II comprised 6 patients without such lesions. FSGS-like lesions were observed in 20.7 +/- 4.6% of glomeruli in group I. Epithelial droplets were observed in 12 of 13 cases in group I, but only one of 6 cases in group II. The incidence of granulated glomerular epithelial cells was significantly higher in group I (p less than 0.0005). The double contour of the basement membrane was more severe in group I than in group II (p less than 0.03). The percentage of glomeruli with FSGS and the number of weeks during which proteinuria of greater than or equal to g/day continued after delivery were positively correlated (r = 0.76, p less than 0.0002). We also found a significant positive correlation between the percentage of glomeruli with FSGS and the amount of proteinuria at delivery and biopsy (r = 0.66, p less than 0.003; r = 0.51, p less than 0.03). However, proteinuria disappeared in all patients. Three of them had successful second pregnancies. We consider that FSGS-like lesions can occur during pregnancy in "pure" pre-eclamptic patients but the lesions may not be progressive. We also suggest that proteinuria and epithelial cell change may be closely related with such lesions.
Nagai
Y
Y
Department of Nephrology, School of Medicine, Toho University, Tokyo, Japan.
Arai
H
H
Washizawa
Y
Y
Ger
Y
Y
Tanaka
M
M
Maeda
M
M
Kawamura
S
S
D000328:Adult; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications / Q000473:pathology*; D006801:Humans; D007678:Kidney Glomerulus / Q000648:ultrastructure; D011225:Pre-Eclampsia / Q000150:complications / Q000473:pathology* / Q000652:urine; D011247:Pregnancy; D011507:Proteinuria