Uludag Koray, Celik Yesim, Yildirimer Nuray, Tekelioglu Fatos, Gunal Ali Ihsan
Department of Nephrology, The University of Health Sciences, Kayseri City Training and Research Hospital, Kayseri, TUR.
Department of Internal Medicine, The University of Health Sciences, Kayseri City Training and Research Hospital, Kayseri, TUR.
Cureus. 2021 Dec 27;13(12):e20739. doi: 10.7759/cureus.20739. eCollection 2021 Dec.
Immunoglobulin M nephropathy (IgMN) is a glomerular disease that may be identified in all age groups, but children and young adults appear to have been affected more frequently in some series. The clinical picture could differ from hematuria to rapidly progressive glomerulonephritis. The main characteristics in pathologic examination are mesangial hypercellularity with a diffuse and granular immunoglobulin M deposition in the glomerular structure. To date, a standardized protocol has not been proposed for IgMN treatment. Systemic corticosteroids, calcineurin inhibitors, cyclophosphamide, and rituximab were agents reported in the literature. We present a 30-year-old woman admitted to the hospital for edema in the lower extremities at the 31st week of pregnancy. She had one abortus previously, and this was her second pregnancy. Renal biopsy performed after delivery was reported as IgMN with mesangial proliferation. She received 1 mg/kg/day prednisone therapy achieving complete remission. This report is the first case of IgMN developed in pregnancy.
免疫球蛋白M肾病(IgMN)是一种肾小球疾病,可在所有年龄组中发现,但在某些系列研究中,儿童和年轻人似乎更常受到影响。临床表现从血尿到快速进展性肾小球肾炎各不相同。病理检查的主要特征是系膜细胞增多,免疫球蛋白M在肾小球结构中呈弥漫性颗粒状沉积。迄今为止,尚未提出针对IgMN治疗的标准化方案。文献报道的治疗药物有全身用糖皮质激素、钙调神经磷酸酶抑制剂、环磷酰胺和利妥昔单抗。我们报告一例30岁女性,在妊娠第31周因下肢水肿入院。她曾有过一次流产,此次是第二次怀孕。产后进行的肾活检报告为系膜增生性IgMN。她接受了每日1mg/kg的泼尼松治疗,实现了完全缓解。本报告是妊娠期间发生IgMN的首例病例。