De novo focal glomerular sclerosis in preeclampsia

Eleven women were selected on the presence, in postpartum renal biopsies, of focal glomerulosclerosis (FGS) superimposed to glomerular lesions of typical pregnancy-induced nephropathy. Ten out of them presented with severe preeclampsia. The renal specimens were examined by light and/or electron and/or immunofluorescence microscopy. The present study gathered clinical and morphological data suggesting that FGS might develop during preeclampsia. In these renal biopsies with FGS and lesions of pregnancy-induced nephropathy a sparse detachment of podocyte was observed at a distance from the segmental lesions by electron microscopy. The latter has also been observed in experimental models of FGS in which FGS is dependent on glomerular hemodynamic alterations. We think that the mechanism of the development of FGS in these pathological pregnancies may be analogous to these experimental models of FGS with hyperfiltration.