Journal of medical case reports · 2025
Primary focal segmental glomerulosclerosis in second trimester pregnancy presenting as rapidly progressive renal failure: diagnostic and therapeutic challenges: a case report.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Petros Adane, Melkie Addisu, Asrat Yidnekachew, Gemechu Fitsum A, Tadesse Yewondwossen
Аннотация
BACKGROUND: Proteinuria in pregnancy is often attributed to preeclampsia, but primary glomerular diseases such as focal segmental glomerulosclerosis can also present during pregnancy, complicating diagnosis and management.
CASE PRESENTATION: A 29-year-old gravida 2, para 1 African woman presented at 25 weeks of gestation with generalized edema and turbid urine. Initial investigations revealed nephrotic-range proteinuria (7.2 g/24 hours), hematuria with red blood cell casts, and deteriorating renal function, with serum creatinine rising from 1.8 to 5 mg/dL within 3 days. Due to worsening renal impairment, pregnancy termination was performed, leading to partial renal recovery, though nephrotic-range proteinuria persisted. Renal biopsy at 4 months postpartum confirmed primary focal segmental glomerulosclerosis.
CONCLUSIONS: Early recognition and prompt treatment of pregnancy-associated glomerular disease are vital for renal recovery. Differentiating focal segmental glomerulosclerosis from preeclampsia is essential, and targeted immunosuppressive therapy can achieve sustained remission, highlighting the need for a multidisciplinary approach.
CASE PRESENTATION: A 29-year-old gravida 2, para 1 African woman presented at 25 weeks of gestation with generalized edema and turbid urine. Initial investigations revealed nephrotic-range proteinuria (7.2 g/24 hours), hematuria with red blood cell casts, and deteriorating renal function, with serum creatinine rising from 1.8 to 5 mg/dL within 3 days. Due to worsening renal impairment, pregnancy termination was performed, leading to partial renal recovery, though nephrotic-range proteinuria persisted. Renal biopsy at 4 months postpartum confirmed primary focal segmental glomerulosclerosis.
CONCLUSIONS: Early recognition and prompt treatment of pregnancy-associated glomerular disease are vital for renal recovery. Differentiating focal segmental glomerulosclerosis from preeclampsia is essential, and targeted immunosuppressive therapy can achieve sustained remission, highlighting the need for a multidisciplinary approach.