A case of hypertensive disorders of pregnancy that developed at 9 weeks of gestation

• Material Type: 記事
• Title: A case of hypertensive disorders of pregnancy that developed at 9 weeks of gestation
• Author/Editor: Saki Hayashi; Naro Ohashi; Daiki Goto
• Publication, Distribution, etc.: 日本 : Springer Nature
• Publication Date: 2021-03-15
• Publication Date (W3CDTF): 2021-03-15
• Periodical title: CEN case reports
• No. or year of volume/issue: 10(4)
• Volume: 10(4)
• ISSN (Periodical Title): 2192-4449
• Text Language Code: eng
• DOI: 10.1007/s13730-021-00592-z; https://doi.org/10.1007/s13730-021-00592-z
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• Date Accepted (W3CDTF): 2022-08-04T20:17:49+09:00
• Date Captured (W3CDTF): 2022-07-22
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• Periodical Title (URI): https://link.springer.com/article/10.1007/s13730-021-00592-z
• Periodical Title (Persistent ID (NDL)): info:ndljp/pid/12312832; https://dl.ndl.go.jp/pid/12312832
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• Summary, etc.: application/pdf; Preeclampsia and superimposed preeclampsia usually develop after 20 weeks of gestation. We report a case of a 35-year-old Japanese woman who developed hypertensive disorders of pregnancy (HDP) before 20 weeks of gestation. She presented with hypertension and proteinuria at 9 and 11 weeks of gestation, respectively, and developed nephrotic syndrome at 17 weeks of gestation. She did not have definite hypertension or urinary abnormalities before pregnancy. The patient was serologically positive for the antinuclear antibody. However, the complement levels were normal and anti-phospholipid antibody was not detected. A renal biopsy performed at 18 weeks of gestation showed diffuse endotheliosis and tip lesions of secondary focal segmental glomerulosclerosis but no hypertensive changes of the arterioles. Although electron microscopic examination showed electron-dense deposits in the subendothelial lesions, they were considered nonspecific plasma exudation by mass spectrometry. An abortion was performed at 20 weeks gestation because the patient’s congestive symptoms due to nephrotic syndrome had worsened and marked fetal growth restriction was observed. After delivery, the patient’s symptoms resolved immediately without any additional treatment; however, continuous antihypertensive medication was required. Finally, the patient was diagnosed with HDP based on the renal biopsy findings and her clinical course after delivery. Compared to previous reports, this case describes the earliest onset of HDP. Thus, HDP should be considered as a differential diagnosis in pregnant women with hypertension or proteinuria presenting with symptoms before 20 weeks of gestation.
• DOI: 10.1007/s13730-021-00592-z; https://doi.org/10.1007/s13730-021-00592-z
• Rights (production): This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1007/s13730-021-00592-z
• Related Material (URI): http://hdl.handle.net/10271/00004060; https://hama-med.repo.nii.ac.jp/records/3937; http://id.ndl.go.jp/digimeta/12312836; https://dl.ndl.go.jp/pid/12312836; https://link.springer.com/content/pdf/10.1007/s13730-021-00592-z.pdf; https://link.springer.com/article/10.1007/s13730-021-00592-z/fulltext.html; https://teikyo-u.repo.nii.ac.jp/records/2010459; https://search.jamas.or.jp/link/ui/2022238465
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• Bibliographic ID (NDL): 12312836; http://id.ndl.go.jp/bib/12312836