A Pregnant Woman with IgA Nephropathy Showing Histological Preeclampsia Findings without Hypertension Treated with Steroids: A Case Report and Literature Review

Nagisa Koda; Kei Matsumoto; Yukio Maruyama; Naomi Ishikawa; Nobuo Tsuboi; Tetsuya Kawamura; Takashi Yokoo

doi:10.2169/internalmedicine.9146-21

CASE REPORTS

A Pregnant Woman with IgA Nephropathy Showing Histological Preeclampsia Findings without Hypertension Treated with Steroids: A Case Report and Literature Review

Nagisa Koda, Kei Matsumoto, Yukio Maruyama, Naomi Ishikawa, Nobuo Tsuboi, Tetsuya Kawamura, Takashi Yokoo

Author information

Nagisa Koda
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan
Kei Matsumoto
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan
Yukio Maruyama
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan
Naomi Ishikawa
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan
Nobuo Tsuboi
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan
Tetsuya Kawamura
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan
Takashi Yokoo
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Japan

Keywords: preeclampsia, IgA nephropathy, gestational proteinuria

JOURNAL OPEN ACCESS

2023 Volume 62 Issue 8 Pages 1195-1202

DOI https://doi.org/10.2169/internalmedicine.9146-21

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Abstract

A 35-year-old woman pregnant with twins developed nephrotic syndrome (NS) at 33 weeks' gestation, but her blood pressure remained within the normal range throughout gestation and puerperium. At 34 weeks' gestation, she delivered healthy twins via Caesarean section. After delivery, she developed massive proteinuria (21.1 g/day) and severe hypoalbuminemia (1.0 g/dL). A renal biopsy performed 19 days after delivery revealed IgA nephropathy (IgAN) and preeclampsia. She was treated with steroids, and the NS gradually resolved. This is a rare case of massive gestational proteinuria with IgAN and preeclampsia pathologically that did not meet the clinical criteria for preeclampsia.

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