Kilpatrick D C, Jazwinska E C, Liston W A, Smart G E
Scott Med J. 1987 Feb;32(1):8-10. doi: 10.1177/003693308703200104.
Two case histories are described with conflicting implications for the etiopathogenesis of pre-eclampsia. In both, typical proteinuric pre-eclampsia developed despite a history of previous normotensive pregnancy. In the first case, the disease was associated with a change of husband, consistent with the view that pre-eclampsia arises from an inadequate maternal immune response to paternal antigens inherited by the fetus. The second case, however, concerned a woman who developed pre-eclampsia for the first time in her third pregnancy by the same reproductive partner. We conclude that either more than one underlying cause can result in the clinical syndrome of pre-eclampsia, or that pre-eclampsia is caused by an environmental factor. The possibility that pre-eclampsia may be initiated by an infectious agent is briefly explored in the light of the clinical histories described and well-established epidemiological, clinical and laboratory data.
本文描述了两个病例，它们对先兆子痫的病因发病机制有着相互矛盾的启示。在这两个病例中，尽管之前有过血压正常的妊娠史，但典型的蛋白尿性先兆子痫仍发生了。在第一个病例中，该病与更换丈夫有关，这与先兆子痫是由于母体对胎儿遗传的父系抗原免疫反应不足而产生的观点一致。然而，第二个病例涉及一名女性，她在第三次妊娠时与同一生殖伴侣首次患上先兆子痫。我们得出的结论是，要么不止一个潜在原因可导致先兆子痫的临床综合征，要么先兆子痫是由环境因素引起的。根据所描述的临床病史以及已确立的流行病学、临床和实验室数据，简要探讨了先兆子痫可能由感染因子引发的可能性。
