Primary antiphospholipid nephropathy beginning during pregnancy.
We describe a 29-year-old pregnant woman at 16 weeks gestation and antiphospholipid antibodies who developed nephrotic syndrome with massive hematuria. Renal biopsy evidenced chronic glomerular lesions of ischemic nature without proliferative changes and immune deposits suggestive of lupus nephritis. Anticoagulation was initiated, along supportive measures, and the patient recovered completely. This case demonstrates that chronic renal lesions of antiphospholipid syndrome may present with marked clinical manifestation including hypertension, massive proteinuria and hematuria, resembling the course of acute thrombotic microangiopathy and/or lupus nephritis.
Klumb
Evandro M
EM
Department of Rheumatology, Universidade do Estado do Rio de Janeiro, Ave. 28 de Setembro no. 77-333, CEP/ZC: 22510-030, Rio de Janeiro, RJ, Brazil. klumb@uol.com.br
de Andrade
Maria Celia
MC
Jesús
Nilson R
NR
Campani
Carlos
C
Campos
Carlos F
CF
Levy
Roger A
RA
Albuquerque
Elisa
E
Cervantes
Vicente
V
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood; D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005313:Fetal Death; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008181:Lupus Nephritis / Q000175:diagnosis; D009404:Nephrotic Syndrome / Q000150:complications* / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011507:Proteinuria / Q000209:etiology
D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants