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“It’s not lupus”. A placental site trophoblastic tumor presenting as a lupus-like paraneoplastic syndrome. A grand round case
Introduction: Placental site trophoblastic tumor (PSTT) is a rare subtype of gestational trophoblastic disease. Association of PSTT and nephrotic syndrome is exceedingly rare and has been described in 8 cases thus far. In all cases hysterectomy was performed within months after onset of symptoms, le...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930597/ https://www.ncbi.nlm.nih.gov/pubmed/33407043 http://dx.doi.org/10.1177/0961203320981765 |
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author | van der Lely, Sarah J Boorsma, Jeffrey Hilhorst, Marc Kers, Jesper Roelofs, Joris Jakulj, Lily van Onna, Marieke |
author_facet | van der Lely, Sarah J Boorsma, Jeffrey Hilhorst, Marc Kers, Jesper Roelofs, Joris Jakulj, Lily van Onna, Marieke |
author_sort | van der Lely, Sarah J |
collection | PubMed |
description | Introduction: Placental site trophoblastic tumor (PSTT) is a rare subtype of gestational trophoblastic disease. Association of PSTT and nephrotic syndrome is exceedingly rare and has been described in 8 cases thus far. In all cases hysterectomy was performed within months after onset of symptoms, leading to immediate remission of nephrotic syndrome, except for one patient who died of complications of PSTT. Case: We describe the history of a woman in which PSTT was discovered years after onset of nephrotic syndrome. Kidney biopsy revealed lupus-like mesangiocapillary nephritis and over time the patient developed additional symptoms mimicking systemic lupus erythematosus (SLE). Discussion: We provide an overview of the literature on this clinical entity and elaborate on its pathophysiology. In addition, we reflect on the phenomenon of anchoring bias, that led physicians to assume the patient had SLE without questioning this diagnosis in the light of the unexplained finding of increased tumor markers. |
format | Online Article Text |
id | pubmed-7930597 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-79305972021-03-18 “It’s not lupus”. A placental site trophoblastic tumor presenting as a lupus-like paraneoplastic syndrome. A grand round case van der Lely, Sarah J Boorsma, Jeffrey Hilhorst, Marc Kers, Jesper Roelofs, Joris Jakulj, Lily van Onna, Marieke Lupus Grand Round Introduction: Placental site trophoblastic tumor (PSTT) is a rare subtype of gestational trophoblastic disease. Association of PSTT and nephrotic syndrome is exceedingly rare and has been described in 8 cases thus far. In all cases hysterectomy was performed within months after onset of symptoms, leading to immediate remission of nephrotic syndrome, except for one patient who died of complications of PSTT. Case: We describe the history of a woman in which PSTT was discovered years after onset of nephrotic syndrome. Kidney biopsy revealed lupus-like mesangiocapillary nephritis and over time the patient developed additional symptoms mimicking systemic lupus erythematosus (SLE). Discussion: We provide an overview of the literature on this clinical entity and elaborate on its pathophysiology. In addition, we reflect on the phenomenon of anchoring bias, that led physicians to assume the patient had SLE without questioning this diagnosis in the light of the unexplained finding of increased tumor markers. SAGE Publications 2021-01-06 2021-03 /pmc/articles/PMC7930597/ /pubmed/33407043 http://dx.doi.org/10.1177/0961203320981765 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Grand Round van der Lely, Sarah J Boorsma, Jeffrey Hilhorst, Marc Kers, Jesper Roelofs, Joris Jakulj, Lily van Onna, Marieke “It’s not lupus”. A placental site trophoblastic tumor presenting as a lupus-like paraneoplastic syndrome. A grand round case |
title | “It’s not lupus”. A placental site trophoblastic tumor presenting as a lupus-like paraneoplastic syndrome. A grand round case |
title_full | “It’s not lupus”. A placental site trophoblastic tumor presenting as a lupus-like paraneoplastic syndrome. A grand round case |
title_fullStr | “It’s not lupus”. A placental site trophoblastic tumor presenting as a lupus-like paraneoplastic syndrome. A grand round case |
title_full_unstemmed | “It’s not lupus”. A placental site trophoblastic tumor presenting as a lupus-like paraneoplastic syndrome. A grand round case |
title_short | “It’s not lupus”. A placental site trophoblastic tumor presenting as a lupus-like paraneoplastic syndrome. A grand round case |
title_sort | “it’s not lupus”. a placental site trophoblastic tumor presenting as a lupus-like paraneoplastic syndrome. a grand round case |
topic | Grand Round |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930597/ https://www.ncbi.nlm.nih.gov/pubmed/33407043 http://dx.doi.org/10.1177/0961203320981765 |
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