Reversible Glomerular Lesions in Toxemia of Pregnancy

Pollak, VictorE.; Pirani, ConradL.; Kark, RobertM.; Muehrcke, RobertC.; Freda, VincentC.; Nettles, J B

doi:10.1016/s0140-6736(56)90424-x

Cited by 56 publications

(8 citation statements)

References 6 publications

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“…Average survival -if these three atypical patients are excluded from the analysis -is only 22 months, a figure almost identical with our own. In the series reported by Pollak et a i [29] the average survival of patients treated with high dose steroids was 22 months at the time the data was reported, while the average survival of that group obviously became greater, the data was already skewed by three patients who had lived an inordinate length of time.…”

Section: Discussionmentioning

confidence: 92%

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Comparison of Azathioprine, Prednisone, and Heparin Alone or Combined in Treating Lupus nephritis

Cade

Spooner

Schlein

et al. 1973

Nephron

139

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50 patients with proliferative glomerulonephritis due to lupus erythematosus were assigned in order of their chronologic appearance at the hospital alternately to treatment with either daily high dose prednisone, azathioprine, prednisone and azathioprine combined, or combined azathioprine and heparin. Prednisone alone was ineffective both from a standpoint of maintaining kidney function or from preserving a state of well being. Only 2 of 15 patients treated with prednisone are doing well with an average survival for the group of 19 months. Azathioprine, alone, appeared very effective with 9 of 13 patients alive and doing well with an average survival of 38 months. Combinations of either azathioprine and prednisone or azathioprine and heparin were most successful, only 2 of 13 in each group died of renal failure. Complications of prednisone administra’ion were high both when prednisone was given alone or in combination with azathioprine.

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Section: Discussionmentioning

confidence: 92%

“…That prednisone exerts a salubrious effect in suppressing the activity of systemic lupus is well accepted [10,19,20,22,23,29,30], The high incidence Table II, Table III, Table IV, azathioTable V, 2 A significant change in the mean creatinine clearance has occurred since the last reporting period for the treatment.…”

Section: Discussionmentioning

confidence: 98%

Comparison of Azathioprine, Prednisone, and Heparin Alone or Combined in Treating Lupus nephritis

Cade

Spooner

Schlein

et al. 1973

Nephron

139

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“…In many investigations, renal biopsies have been deferred to the postpartum period, when a pre‐eclamptic lesion may already have resolved or findings may be determined by the healing stage of the lesion. Regression of some glomerular lesions in pre‐eclampsia can be seen as early as the first week postpartum 11–15 and complete resolution has been reported within four weeks 12 . Renal function is usually restored within only a few days after delivery.…”

Section: Discussionmentioning

confidence: 99%

Glomerular endotheliosis in normal pregnancy and pre‐eclampsia

Strevens

Wide‐Swensson

Hansen

et al. 2003

BJOG

145

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Objective To investigate the proportion of women with findings characteristic for pre‐eclampsia, as opposed to renal disease, in a controlled study of hypertensive pregnant women undergoing antepartum renal biopsy. Design An observational prospective controlled study. Setting University Hospital of Lund, Sweden. Sample Thirty‐six previously healthy women with hypertensive disease in pregnancy, consecutively admitted to the antenatal ward at onset of disease during a 20 month period and giving informed consent, as well as 12 voluntary healthy pregnant controls. Methods Renal biopsy samples were obtained from all participants and evaluated by light microscopy, electron microscopy and immunofluorescence techniques. Main outcome measures Presence and degree of glomerular endotheliosis. Results Glomerular endotheliosis was present in all women with pre‐eclampsia and gestational hypertension, and in 5 of the 12 controls, although significant differences in the degree of endotheliosis were found between the groups. Clinically undetected renal disease was not diagnosed in any of the women. Conclusion Glomerular endotheliosis was found in women with normal pregnancy as well as in both non‐proteinuric and proteinuric hypertension and is consequently not, as earlier believed, pathognomonic for pre‐eclampsia. The transition between normal term pregnancy, gestational hypertension and pre‐eclampsia appears to be a continuous process, perhaps of increasing adaptation to pregnancy. Pre‐eclampsia may be the extreme of the adaptational process, rather than a separate abnormal condition. Clinically undetected renal disease could be a rare cause of hypertension in pregnancy.

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“…It should be emphasized that it can be extremely difficult to differentiate pre-eclampsia from glomernlonephritis in the latter half of pregnancy, other than by renal biopsy, which should show specific histological changes in each condition (Pollak et al, 1956;Altchek, 1961).…”

Section: Incidence and Diagnosis Of Renal Disease In Pregnancymentioning

confidence: 99%