Primigesta, 21 years old, with no history.
After a 21-week pregnancy, she suddenly developed generalized edema without arterial hypertension (AHT).
The patient was hospitalized and NS showed proteinuria of 14 g/day, with no renal functional impairment (creatininemia 0.6 mg/dL).
Blood count, glycemia and oral glucose tolerance test were normal.
Total cholesterol 387 mg/dL
Urinary sediment showed 15-20 red blood cells per field.
Antinuclear antibodies (ANA), neutrophil cytoplasm (ANCA), anti-DNA, anticardiolipin, lupus anticoagulant; complement C3 and C4, VDRL, serology for HIV, hepatitis B and C were all negative.
Echotomography: kidneys with normal appearance and size.
Rest, salt restriction and furosemide began.
Massive proteinuria without melting edema
Given the severity of the condition (albuminemia 1.2 g/dL; proteinemia 3.2 g/dL), the potential risks of an empirical steroidal therapy and the remaining five months for the termination of pregnancy, a prior informed consent was obtained.
