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Case Rep Nephrol Urol. 2013 Jan;3(1):9-15. doi: 10.1159/000346862. Epub 2013 Jan 26.

Multiple pathologies in the kidney biopsy of a recently pregnant woman.

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Division of Nephrology, Department of Internal Medicine, State University of New York, Buffalo, N.Y., USA.


We report a 42-year-old woman with underlying hypertension, mild renal dysfunction and proteinuria who presented as an obstetric emergency with uncontrolled hypertension and nephrotic syndrome. The rapid deterioration in her kidney function and worsening of her symptoms led to an urgent termination of her twin pregnancy. Although a clinical improvement was noticed within 10 days, the persistently elevated serum creatinine required further evaluation. A kidney biopsy showed changes consistent with acute tubular necrosis and resolving preeclampsia superimposed on focal segmental glomerulosclerosis and hypertensive kidney disease. The importance of a kidney biopsy in confirming clinical suspicions and determining patient prognosis is emphasized.


Acute tubular necrosis; Focal segmental glomerulosclerosis; Hypertension; Preeclampsia

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