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首页> 外文期刊>Case Reports in Nephrology >A Case of De Novo Antiglomerular Basement Membrane Disease Presenting during Pregnancy
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A Case of De Novo Antiglomerular Basement Membrane Disease Presenting during Pregnancy

机译：妊娠期间揭示德诺抗抗血压膜病的案例

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Background . Acute kidney injury (AKI) requiring dialysis during pregnancy is uncommon. We present a case of a young female diagnosed with antiglomerular basement membrane (anti-GBM) disease during pregnancy. Case Presentation . A 23-year-old woman approximately 15 weeks pregnant experienced weakness, nausea, vomiting, and anorexia for one week and anuria for 48 hours. No known drug allergies and no significant social or family history for kidney or genitourinary disease were reported. Laboratory analysis revealed anemia, life-threatening hyperkalemia, AKI, and elevated antiglomerular basement membrane (GBM) antibodies. Renal biopsy revealed 100% cellular crescents, confirming the diagnosis. The patient was treated using plasmapheresis and methylprednisolone followed by oral steroids, azathioprine, and tacrolimus. At 24 weeks and 4 days of gestation, the patient had hypoxic respiratory failure as well as preterm premature rupture of membranes. Due to the development of infection and lack of renal recovery, immunosuppression was discontinued. At 28 weeks and 0 days of gestation, the patient developed uncontrollable hypertension requiring emergent delivery. Postpartum, her hypertension improved without signs of preeclampsia though still requires dialysis. Discussion . Pregnancy presents a unique challenge for providers treating patients with anti-GBM disease. Fetal safety should be considered and risks thoroughly discussed with the patient when choosing an immunosuppressive regimen for this condition.
机译：背景 。怀孕期间需要透析的急性肾脏损伤（AKI）罕见。我们在怀孕期间提出了一种诊断患有抗原基底膜（抗GBM）疾病的年轻女性。案例演示。一个23岁的女性约15周怀孕经历了弱点，恶心，呕吐和厌食，持续了48小时。据报道，没有已知的药物过敏，没有显着的社会或家族史为肾脏或泌尿病疾病。实验室分析揭示了贫血，危及生命的高钾血症，AKI和升高的抗尖端膜（GBM）抗体。肾活检显示100％的细胞新月形，确认诊断。使用血浆粉刺和甲基己酮醇，然后口服类固醇，唑类唑和标准杆菌治疗患者。在妊娠24周和4天，患者患有缺氧呼吸衰竭以及早产的膜过早破裂。由于感染的发展和缺乏肾脏恢复，停止免疫抑制。在妊娠28周和0天后，患者产生了无法控制的高血压，需要紧急交付。产后，她的高血压没有先兆子痫的迹象，虽然仍需要透析。讨论 。怀孕对治疗抗GBM疾病患者的提供者提供了独特的挑战。应考虑胎儿安全性，并在为这种条件选择免疫抑制方案时与患者彻底讨论风险。

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