Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
CEN Case Rep. 2021 Aug;10(3):315-319. doi: 10.1007/s13730-020-00568-5. Epub 2021 Jan 6.
A 32-year-old Japanese woman at 8 weeks of gestation was admitted to our hospital for systemic edema, hypoalbuminemia, and severe proteinuria. The patient had a history of generalized alopecia and migraine. We diagnosed nephrotic syndrome, and renal biopsy revealed minimal change nephrotic syndrome (MCNS). We administered 1000 mg/day of methylprednisolone for 3 days. Oral corticosteroid therapy was followed by 40 mg of prednisolone daily. We carefully selected concomitant medication after considering organogenesis. Before and after renal biopsy, we administered heparin, antithrombin III, and immunoglobulin agents as appropriate. The patient achieved complete remission on day 8 of treatment and gave birth to a boy at 37 weeks of gestation without recurrence. MCNS during pregnancy is rare, and there is no established treatment. In conclusion, we present a case of a pregnant woman with MCNS during organogenesis. Early treatment initiation can provide a good prognosis for both mother and child.
一位 32 岁的日本女性,妊娠 8 周时因全身水肿、低白蛋白血症和严重蛋白尿而入院。该患者有全身性脱发和偏头痛病史。我们诊断为肾病综合征,肾活检显示为微小病变性肾病综合征(MCNS)。我们给予患者甲基泼尼松龙 1000mg/天,连续治疗 3 天。随后给予患者口服皮质类固醇治疗,每日剂量为 40mg 的泼尼松。我们在考虑器官发生期的情况下,仔细选择了伴随药物。在进行肾活检前后,我们根据需要给予了肝素、抗凝血酶 III 和免疫球蛋白制剂。患者在治疗第 8 天达到完全缓解,并在 37 周妊娠时分娩了一名男婴,且未复发。妊娠期间的 MCNS 较为罕见,且目前尚无标准的治疗方法。总之,我们报告了一例器官发生期的妊娠合并 MCNS 的病例。早期治疗的启动可为母婴提供良好的预后。