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Membranous nephropathy that first presented in pregnancy
Yumie Aoshima1, Masayuki Iyoda, Ai Nakazawa
1Department of Medicine, Showa University School of Medicine, Japan.
Internal Medicine (Tokyo, Japan)
|September 3, 2013
Summary
Idiopathic membranous nephropathy (MN) can develop during pregnancy, presenting as nephrotic syndrome (NS). Early diagnosis and management, including considering pregnancy termination, may lead to partial remission of NS.
Area of Science:
- Nephrology
- Obstetrics & Gynecology
- Pathology
Background:
- Pregnancy can unmask or exacerbate underlying renal conditions.
- Nephrotic syndrome (NS) during pregnancy requires careful evaluation for underlying causes.
- Idiopathic membranous nephropathy (MN) is a potential cause of NS.
Observation:
- A 37-year-old pregnant woman presented with proteinuria and hematuria at 13 weeks gestation.
- Proteinuria progressed to nephrotic syndrome (NS) by 17 weeks gestation, unresponsive to prednisolone and methylprednisolone pulse therapy.
- The patient underwent elective abortion at 21 weeks gestation, after which NS showed partial remission.
Findings:
- Renal biopsy confirmed membranous nephropathy (MN).
- No secondary causes of MN were identified.
- This case represents the first report of subclinical idiopathic MN developing during pregnancy.
Implications:
- Pregnancy-associated nephrotic syndrome warrants thorough investigation for idiopathic membranous nephropathy.
- Management strategies may need to consider the impact on both maternal renal health and pregnancy.
- This case highlights the importance of recognizing idiopathic MN as a potential complication of pregnancy.
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