Kidney involvement in a patient affected by placental site trophoblastic tumor.
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| Abstract |
We report a 42-year-old woman who presents a few days after a spontaneous incomplete abortion at the ninth week of pregnancy with hypertension and nephrotic syndrome. Curettage findings and increased values for the β subunit of human chorionic gonadotrophin were suspicious for a trophoblastic disease. A uterine placental site trophoblastic tumor was diagnosed 2 months later after hysterectomy and treated successfully using chemotherapy. Kidney biopsy showed features consistent with an unusual form of thrombotic microangiopathy characterized by the presence of large thrombus-like structures occluding the capillary lumina and smaller aggregates in the mesangium and along glomerular basement membranes. These deposits were positive for immunoglobulin M, C4, C1q, κ and λ light chains, and fibrinogen. Electron microscopy showed fibrin deposits located primarily in the subendothelial space. The differential diagnosis of this presentation included pre-eclamptic nephropathy, Waldenström disease, lupus anticoagulant glomerulonephritis, systemic lupus erythematosus, and cryoglobulinemic glomerulonephritis. We review the pathogenic mechanisms involved in this case.
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| Authors | Gianna Mazzucco, Loredana Colla, Guido Monga |
| Journal | American journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 57 Issue 3 Pg. 516-20 (Mar 2011) ISSN: 1523-6838 [Electronic] United States |
| PMID | 21257242 (Publication Type: Case Reports, Journal Article) |
| Copyright | Copyright © 2011 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. |
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