Lo Jamie O, Kerns Eric, Rueda Jose, Marshall Nicole E
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and.
J Matern Fetal Neonatal Med. 2014 Aug;27(12):1282-4. doi: 10.3109/14767058.2013.852178. Epub 2013 Oct 24.
New onset minimal change disease (MCD) is rare in pregnancy with the potential for serious complications including acute kidney injury (AKI).
A case of MCD was diagnosed at 19 weeks gestation by renal biopsy. Within one month of starting steroids, the patient experienced normalization of renal function and resolution of nephrotic syndrome, although hemodialysis was needed as a temporizing measure.
The differential diagnosis for new onset proteinuria in pregnancy should include MCD. In selected cases, renal biopsy can be used to confirm diagnosis, and when indicated, hemodialysis should be instituted while awaiting a response to steroid therapy.
新发微小病变病(MCD)在妊娠期罕见,有发生包括急性肾损伤(AKI)在内的严重并发症的可能。
一名患者在妊娠19周时经肾活检诊断为MCD。开始使用类固醇药物治疗后的一个月内,患者肾功能恢复正常,肾病综合征得到缓解,不过作为临时措施需要进行血液透析。
妊娠期新发蛋白尿的鉴别诊断应包括MCD。在某些病例中,肾活检可用于确诊,如有指征,在等待类固醇治疗起效时应进行血液透析。