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1.
Rev. colomb. obstet. ginecol ; 63(3): 280-285, jul.-sept. 2012.
Article in Spanish | LILACS | ID: lil-655548

ABSTRACT

Objetivo: presentar el caso de una mujer de 19 años con embarazo de 24 semanas con diagnóstico de preeclampsia severa y proteinuria en rango nefrótico, y revisar la fisiopatología, histopatología y el pronóstico de la proteinuria masiva en pacientes con preeclampsia severa.Materiales y métodos: Materiales y métodos: se presenta el caso de una paciente de 19 años de edad (G1P0) con embarazo de 24 semanas y hallazgo de cifras tensionales de 120/90 mmHg, quien es hospitalizada en la Clínica Universidad de La Sabana, hospital privado de alta complejidad, por proteinuria aislada de 220 mg/dl para clasificación de trastorno hipertensivo en el embarazo. El estudio de proteinuria en 24 h mostró un resultado inicial de 9 g. Se solicitan exámenes adicionales para preeclampsia los cuales se encuentran dentro de rangos normales. Se realizaron estudios periódicos de proteinuria en 24 horas con tendencia al aumento, cuyo valor máximo fue de 14 g. Posteriormente presenta elevación de cifras tensionales en rango de severidad asociado a síntomas de vasoespasmo e inminencia de eclampsia, por lo cual se finaliza gestación a las 25,4 semanas por cesárea, con posterior fallecimiento del recién nacido. La paciente persiste con cifras tensionales elevadas durante el puerperio, requiriendo manejo antihipertensivo. Finalmente se logra un adecuado control y se da egreso.Se realizó una búsqueda de literatura médica relativa al caso en las bases de datos Medline/PubMed, Jstor y Lilacs con la terminología MeSH “pregnancy”, “preeclampsia”, “proteinuria” y “nephrotic syndrome”.Resultados: se encontraron 26 artículos, de los cuales 11 estaban relacionados con proteinuria dentro de un estado de preeclampsia. A partir de estos se realizó una búsqueda en bola de nieve encontrándose un total final de 38 artículos. Conclusión: la presencia de proteinuria masiva y su asociación con preeclampsia aún no ha sido claramente esclarecida. Por esto es necesario establecer rangos de proteinuria dentro de los criterios de severidad que conllevan al desarrollo de posteriores complicaciones materno-fetales.


Objective: Presenting the case of a 19-year-old twenty-four weeks pregnant female who had been diagnosed with severe preeclampsia and neophrotic-range proteinuria and reviewing the physiopathology, histopathology and prognosis of massive proteinuria in severe preeclampsia patients. Materials and methods: the case of a 19-year-old twenty-four weeks pregnant G1P0 patient having 120/90 mmHg blood pressure figures is presented; she was hospitalized in the Universidad de la Sabana teaching hospital, a high-complexity private hospital due to 220 mg/dl isolated proteinuria for classification of hypertensive disorder during pregnancy. the proteinuria study gave an initial 9 g/24 hours result. Additional exams were requested for preeclampsia; these came within normal ranges. Periodic 24 hour proteinuria studies were made, revealing a tendency to increase (14 g maximum). She then presented high blood pressure in a range of severity associated with symptoms of vasospasm and imminent eclampsia; the pregnancy was thus terminated at 25.4 weeks by caesarean (the newborn dying afterwards). the patient continued to have high blood pressure figures during the puerperium, requiring anti-hypertensive management. Adequate control was finally achieved and she was discharged. A search was made of the pertinent medical literature relating to the case in Medline/PubMed, JStOR and Lilacs databases using the MeSH search terms “pregnancy”, “preeclampsia”, “proteinuria”, and “nephrotic syndrome”. Results: 26 articles were found, 11 of them being related to proteinuria within a state of preeclampsia. A snowball search was then made from these, leading to another 38 articles.Conclusion: the presence of massive proteinuria and its association with preeclampsia has still not been clearly elucidated. Ranges of proteinuria must thus be established within criteria regarding severity which lead to further maternal-fetal complications developing.


Subject(s)
Adult , Female , Pregnancy , Nephrotic Syndrome , Pre-Eclampsia , Proteinuria
2.
Korean Journal of Obstetrics and Gynecology ; : 1093-1098, 2003.
Article in Korean | WPRIM | ID: wpr-213865

ABSTRACT

OBJECTIVE: This study was investigated on the relationship the degrees of proteinuria with the maternal characteristics, maternal and the neonatal outcomes. The correlation between the result of single urine protein- to-creatinine ratio and the amount of 24 hour urine protein was also investigated. METHODS: From December 1999 to June 2002, 63 patients were enrolled in this study. They were divided into two groups by the degree of proteinuria at 24 hour urine, single urine and dip stick test, respectively. Each two groups was compared with the maternal characteristics, gestational age, the maternal and the neonatal outcomes. The correlation between single urine protein-to-creatinine ratio and the amount of 24 hour urine protein was analyzed statistically. RESULTS: Each two groups of single urine and dip stick test had no differences in maternal characteristics, gestational age, maternal and the neonatal outcomes. However, in two of 24 hour urine, massive proteinuria group had poor maternal and neonatal outcomes compared with control group (p value 0.01). Single urine protein-to-creatine ratio and the amount 24 hour urine protein had borderline correlation (p value 0.064). CONCLUSION: The presence of proteinuria influences on maternal and neonatal outcomes. Moreover, the massive proteinuria group had more maternal and neonatal complication than control group. The result of single urine protein-to-creatine ratio had borderline correlation with the amount of protein in 24 hour urine collection.


Subject(s)
Female , Humans , Pregnancy , Pregnancy , Gestational Age , Hypertension, Pregnancy-Induced , Proteinuria , Urine Specimen Collection
3.
Korean Journal of Nephrology ; : 926-931, 2001.
Article in Korean | WPRIM | ID: wpr-102794

ABSTRACT

Waldenstr m's macroglobulinemia(WM) is a disorder of malignant proliferation of plasmacyoid lymphocytes and monoclonal immunoglobulin M. The renal complications of WM are less common and severe than that of multiple myeloma. We present a case of WM which involved the kidney as massive proteinuria, hematuria and renal failure. A biopy specimen of the kidney reveals the intraglomerular hyaline thrombi of immunoglobulin M paraprotein. Three cycles of plasmapheresis and systemic chemotherapy with chlorambucil and prednisolone show improvement in his renal manifestations. We suppose the glomerulonephritis caused by hyaline thrombi in WM may be reversible, at least in its early stage.

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