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Podocytopathy Associated with IgA Nephropathy in Pregnancy: A Challenging Association

IgA nephropathy is the most common form of primary glomerulonephritis. While associations of IgA and other glomerular diseases have been described, the association of IgA nephropathy with “primary” podocytopathy is rare and has not been reported in pregnancy, due in part to the infrequent use of kid...

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Autores principales: Orozco Guillén, Alejandra, Soto Abraham, Virgilia, Moguel Gonzalez, Bernardo, Piccoli, Giorgina Barbara, Madero, Magdalena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004185/
https://www.ncbi.nlm.nih.gov/pubmed/36902674
http://dx.doi.org/10.3390/jcm12051888
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author Orozco Guillén, Alejandra
Soto Abraham, Virgilia
Moguel Gonzalez, Bernardo
Piccoli, Giorgina Barbara
Madero, Magdalena
author_facet Orozco Guillén, Alejandra
Soto Abraham, Virgilia
Moguel Gonzalez, Bernardo
Piccoli, Giorgina Barbara
Madero, Magdalena
author_sort Orozco Guillén, Alejandra
collection PubMed
description IgA nephropathy is the most common form of primary glomerulonephritis. While associations of IgA and other glomerular diseases have been described, the association of IgA nephropathy with “primary” podocytopathy is rare and has not been reported in pregnancy, due in part to the infrequent use of kidney biopsy during pregnancy, and a frequent overlap with preeclampsia. We report the case of a 33-year-old woman with normal kidney function, referred in the 14th gestational week of her second pregnancy, due to nephrotic proteinuria and macroscopic hematuria. The baby’s growth was normal. The patient reported episodes of macrohematuria one year previously. A kidney biopsy performed at 18 gestational weeks confirmed IgA nephropathy, associated with extensive podocyte damage. Treatment with steroids and tacrolimus led to remission of proteinuria and a healthy baby, adequate for gestational age, was delivered at 34 gestational weeks and 6 days (premature rupture of membranes). Six months after delivery, proteinuria was about 500 mg per day, with normal blood pressure and kidney function. This case highlights the importance of timely diagnosis in pregnancy and underlines that good maternal and fetal outcomes can be achieved with appropriate treatment, even in complex or severe cases.
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spelling pubmed-100041852023-03-11 Podocytopathy Associated with IgA Nephropathy in Pregnancy: A Challenging Association Orozco Guillén, Alejandra Soto Abraham, Virgilia Moguel Gonzalez, Bernardo Piccoli, Giorgina Barbara Madero, Magdalena J Clin Med Case Report IgA nephropathy is the most common form of primary glomerulonephritis. While associations of IgA and other glomerular diseases have been described, the association of IgA nephropathy with “primary” podocytopathy is rare and has not been reported in pregnancy, due in part to the infrequent use of kidney biopsy during pregnancy, and a frequent overlap with preeclampsia. We report the case of a 33-year-old woman with normal kidney function, referred in the 14th gestational week of her second pregnancy, due to nephrotic proteinuria and macroscopic hematuria. The baby’s growth was normal. The patient reported episodes of macrohematuria one year previously. A kidney biopsy performed at 18 gestational weeks confirmed IgA nephropathy, associated with extensive podocyte damage. Treatment with steroids and tacrolimus led to remission of proteinuria and a healthy baby, adequate for gestational age, was delivered at 34 gestational weeks and 6 days (premature rupture of membranes). Six months after delivery, proteinuria was about 500 mg per day, with normal blood pressure and kidney function. This case highlights the importance of timely diagnosis in pregnancy and underlines that good maternal and fetal outcomes can be achieved with appropriate treatment, even in complex or severe cases. MDPI 2023-02-27 /pmc/articles/PMC10004185/ /pubmed/36902674 http://dx.doi.org/10.3390/jcm12051888 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Orozco Guillén, Alejandra
Soto Abraham, Virgilia
Moguel Gonzalez, Bernardo
Piccoli, Giorgina Barbara
Madero, Magdalena
Podocytopathy Associated with IgA Nephropathy in Pregnancy: A Challenging Association
title Podocytopathy Associated with IgA Nephropathy in Pregnancy: A Challenging Association
title_full Podocytopathy Associated with IgA Nephropathy in Pregnancy: A Challenging Association
title_fullStr Podocytopathy Associated with IgA Nephropathy in Pregnancy: A Challenging Association
title_full_unstemmed Podocytopathy Associated with IgA Nephropathy in Pregnancy: A Challenging Association
title_short Podocytopathy Associated with IgA Nephropathy in Pregnancy: A Challenging Association
title_sort podocytopathy associated with iga nephropathy in pregnancy: a challenging association
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10004185/
https://www.ncbi.nlm.nih.gov/pubmed/36902674
http://dx.doi.org/10.3390/jcm12051888
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