title: Urinary protein selectivity in nephrotic syndrome and pregnancy: resurrection of a biomarker when renal biopsy is contraindicated.
abstract: Significant proteinuria in pregnancy can indicate the presence of serious conditions requiring investigation and treatment. The nephrotic syndrome in pregnancy presents a multitude of difficulties and is a relative contraindication of renal biopsy, particularly in the third trimester. We present a case of nephrotic syndrome of unknown cause presenting at 33 weeks of pregnancy. With renal biopsy contraindicated, we used the urine protein selectivity test, a largely discarded test predicting steroid-responsive nephrotic syndrome, to help inform the decision to give steroids. This led to a successful clinical outcome including the avoidance of neonatal ICU care for baby.
authors: Manchester Institute of Nephrology & Transplantation , Manchester Royal Infirmary , Manchester , UK.
authors: Patrick
authors: P
authors: Hamilton
authors: Maternal & Fetal Health Research Centre , St Mary's Hospital , Manchester , UK.
authors: Jenny
authors: J
authors: Myers
authors: Department of Obstetrics & Maternal and Fetal Medicine , St Mary's Hospital , Manchester , UK.
authors: Joanna
authors: J
authors: Gillham
authors: Department of Clinical Biochemistry , Manchester Royal Infirmary , Manchester , UK.
authors: Gwen
authors: G
authors: Ayers
authors: Manchester Institute of Nephrology & Transplantation , Manchester Royal Infirmary , Manchester , UK.
authors: Nina
authors: N
authors: Brown
authors: Manchester Institute of Nephrology & Transplantation , Manchester Royal Infirmary , Manchester , UK.
authors: Michael
authors: M
authors: Venning
keywords: biomarker; nephrotic syndrome; pregnancy; protein selectivity; renal biopsy