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狼疮性肾炎:妊娠期的管理挑战

Lupus nephritis: management challenges during pregnancy.

作者信息

Gholizadeh Ghozloujeh Zohreh, Singh Tripti, Jhaveri Kenar D, Shah Silvi, Lerma Edgar, Abdipour Amir, Norouzi Sayna

机构信息

Department of Medicine, Division of Nephrology, Loma Linda University School of Medicine, Loma Linda, CA, United States.

Department of Medicine, Division of Nephrology, University of Wisconsin, Madison, WI, United States.

出版信息

Front Nephrol. 2024 Jun 4;4:1390783. doi: 10.3389/fneph.2024.1390783. eCollection 2024.

Abstract

Lupus nephritis (LN), a severe complication of systemic lupus erythematosus (SLE), leads to significant kidney inflammation and damage and drastically increases mortality risk. Predominantly impacting women in their reproductive years, LN poses specific risks during pregnancy, including pre-eclampsia, growth restrictions, stillbirth, and preterm delivery, exacerbated by lupus activity, specific antibodies, and pre-existing conditions like hypertension. Effective management of LN during pregnancy is crucial and involves carefully balancing disease control with the safety of the fetus. This includes pre-conception counseling and a multidisciplinary approach among specialists to navigate the complexities LN patients face during pregnancy, such as distinguishing LN flare-ups from pregnancy-induced conditions. This review focuses on exploring the complex dynamics between pregnancy and LN, emphasizing the management difficulties and the heightened risks pregnant women with LN encounter.

摘要

狼疮性肾炎(LN)是系统性红斑狼疮(SLE)的一种严重并发症,会导致显著的肾脏炎症和损伤,并大幅增加死亡风险。LN主要影响育龄女性,在怀孕期间会带来特定风险,包括子痫前期、生长受限、死产和早产,狼疮活动、特定抗体以及高血压等原有疾病会使这些风险加剧。孕期有效管理LN至关重要,需要在疾病控制与胎儿安全之间仔细权衡。这包括孕前咨询以及专家之间的多学科方法,以应对LN患者在孕期面临的复杂情况,比如区分LN病情发作与妊娠引起的状况。本综述着重探讨妊娠与LN之间的复杂动态关系,强调管理困难以及LN孕妇所面临的更高风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3d3/11183321/b18d7c3bbe3f/fneph-04-1390783-g001.jpg

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