Angiogenic factors and renal disease in pregnancy.

Case Reports in Obstetrics and Gynecology
Julie S RheeSarosh Rana

Abstract

Background. Preeclampsia is difficult to diagnose in patients with underlying renal disease and proteinuria. Prior studies show that there is an angiogenic factor imbalance with elevated levels of antiangiogenic proteins soluble fms-like tyrosine kinase 1 (sFlt1) and soluble endoglin (sEng) and reduced levels of the proangiogenic protein, placental growth factor (PlGF) in women with preeclampsia. These angiogenic biomarkers may be useful in distinguishing preeclampsia from other conditions of pregnancy, which may present with overlapping clinical characteristics. Cases. Case 1: A multiparous woman at 18 weeks gestation with nephrotic syndrome presented with hypertensive emergency and worsening renal insufficiency. She underwent induction of labor for severe preeclampsia. Her sFlt1 and sEng levels were at the 97 percentile while her PlGF level was undetectable (less than the 1st percentile). Case 2: A nulliparous woman with lupus nephritis at 22 weeks gestation presented with fetal demise and heart failure. Three weeks previously, the patient had developed thrombocytopenia and hypertensive urgency. She underwent dilation and evacuation. Her angiogenic profile was consistent with severe preeclampsia. Conclusion. Angiogenic factor...Continue Reading

References

Feb 7, 2004·The New England Journal of Medicine·Richard J LevineS Ananth Karumanchi
Sep 24, 2005·Obstetrics and Gynecology·UNKNOWN ACOG Committee on Practice Bulletins--Obstetrics
Sep 8, 2006·The New England Journal of Medicine·Richard J LevineUNKNOWN CPEP Study Group
May 6, 2008·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Hui Yi ShanMark E Williams
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Oct 24, 2009·American Journal of Obstetrics and Gynecology·Stefan VerlohrenHolger Stepan
Nov 11, 2009·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Juan Pedro KusanovicSonia S Hassan

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Methods Mentioned

BETA
X-ray
enzyme-linked immunosorbent assays
cesarean section

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