IgA nephropathy: remission during pregnancy and relapse in the puerperium

A 39-year-old woman, with proteinuria and microhematuria, at about the 8th week of pregnancy showed a reduction in proteinuria. After the 16th week, proteinuria disappeared. In the 40th week, the patient spontaneously delivered a 1.990-kg still-born female. Six days later, blood pressure increased (to 150/100 mm Hg), and laboratory examinations showed that proteinuria was 2.7 g/24 h. Given that urinalysis confirmed the presence of proteinuria, 6 weeks later, a renal biopsy was performed. The final diagnosis was IgA nephropathy. It is possible that the presence of the fetus may have led to changes in the maternal immunological system which may have attenuated the immunopathogenic mechanisms responsible for IgA nephropathy.