title: Evaluation of lupus nephritis during pregnancy by renal biopsy.
abstract: Patients with lupus nephritis frequently exhibit increasing proteinuria, hypertension and deterioration of renal function due to either active lupus nephritis, chronic lupus nephritis and/or superimposed preeclampsia during pregnancy. Percutaneous renal biopsies were therefore performed in 3 women with systemic lupus erythematosus during pregnancy and immediately postpartum in a fourth woman to evaluate their renal disease during pregnancy. Mean serum creatinine at renal biopsy was 2.9 mg/dl, with a mean creatinine clearance of 66 ml/min and protein excretion of 5.3 g/day. All patients had grade IV lupus nephritis and received pulse methylprednisolone immediately; 3 received cyclophosphamide. All 3 patients with crescent formation developed endstage renal disease within 3 years. The fourth patient has normal renal function 3 years after biopsy. Percutaneous renal biopsies during pregnancy in women with lupus nephritis provide an accurate histopathologic diagnosis and are important in providing appropriate therapy, counseling and prognosis.
authors.affiliation: Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA.
authors.forename: N K
authors.initials: NK
authors.lastname: Krane
authors.forename: V
authors.initials: V
authors.lastname: Thakur
authors.forename: H
authors.initials: H
authors.lastname: Wood
authors.forename: S
authors.initials: S
authors.lastname: Meleg-Smith
mesh_terms: D000328:Adult; D001706:Biopsy; D003520:Cyclophosphamide / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008181:Lupus Nephritis / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D008775:Methylprednisolone / Q000627:therapeutic use; D008854:Microscopy, Electron; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000473:pathology*; D011644:Puerperal Disorders / Q000188:drug therapy / Q000473:pathology; D013997:Time Factors
chemical_list: D003520:Cyclophosphamide; D011241:Prednisone; D008775:Methylprednisolone