1/4. Perinatal vasoconstrictive renal insufficiency associated with maternal nimesulide use.A full-term newborn developed oliguric renal failure at 24 hr of life, which persisted for several days. Her mother ingested therapeutic doses of nimesulide, a non-steroidal anti-inflammatory (cyclo-oxygenase-2 inhibitor) drug, during the last 2 weeks of pregnancy. She was found at delivery to have developed oligohydramnion, esophagitis, and a bleeding peptic ulcer. The infant's fractional excretion of sodium was very low (0.5%) pointing for a severe vasoconstrictive mechanism involved. Renal sonogram showed hyperechogenic medullary papillae, which resolved during convalescence. This case emphasizes the importance of renal prostagandins in the control of vascular tone and sodium homeostasis. This is the first report of an adverse effect of fetal renal circulation by maternal ingestion of nimesulide.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/4. ovulation induction and early pregnancy loss in a woman susceptible to autoimmune diseases: a possible interrelationship.We report a 34-year-old woman with sequentially occurring autoimmune diseases that are possibly triggered by numerous ovulation inductions. At the ages of 26-32 years, she experienced 27 uncontrolled ovulation induction cycles using clomiphene citrate (CC) or CC plus human menopausal gonadotropin plus human chorionic gonadotropin. She became pregnant at the ages of 27, 30 and 31 with subsequent pregnancy loss in the 28th, 8th and 10th week of gestation, respectively. insulin-dependent diabetes mellitus (IDDM) developed at the age of 28. During the second year of ovulation induction, at the age of 27, she developed arthralgia that worsened and became migratory from the age of 31. thrombocytopenia appeared at the age of 33. The diagnosis of systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) was established at the age of 34. To the best of our knowledge, this is the first case of concurrent IDDM, SLE and APS in a patient associated with ovulation inductions. Excessive levels of estradiol achieved during the ovulation inductions could play a role in the expression of multiple autoimmune diseases in the susceptible woman.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
3/4. Transient bilateral osteoporosis of the hip in pregnancy. A case report and review of the literature.osteoporosis of the hip is a rare complication of pregnancy, the diagnosis of which can only be determined by radiologic means. Differentiation between osteonecrosis and osteoporosis remains problematic in some cases. magnetic resonance imaging was reported as useful for the diagnosis of osteoporosis. Treatment of osteoporosis of the hip in pregnancy should be conservative including physical therapy, restricted weight bearing and analgetic therapy. We report an unusual case of bilateral transient osteoporosis of the hip in pregnancy.- - - - - - - - - - ranking = 7keywords = pregnancy (Clic here for more details about this article) |
4/4. Transient osteoporosis of the hip during pregnancy: a case report.Transient osteoporosis associated with pregnancy is a rare, self-limiting skeletal disorder, the origin of which remains unclear. We report the case of a 36-year-old Japanese woman who developed pain in the left hip, groin, and knee in the seventh month of pregnancy. The pain gradually worsened and prevented weight-bearing. The hip and knee pain progressed to bilateral involvement and persisted after an emergent cesarean section at 35 weeks. Radiographs after delivery revealed gross osteopenia of both the femoral heads, left distal femur, and proximal tibia, consistent with transient osteoporosis associated with pregnancy. The patient remained mostly wheelchair-dependent because of severe hip and knee pain. Several weeks later, the patient was started on alendronate, a biphosphonate, which provided dramatic relief of hip and knee pain. The patient's ambulatory function subsequently improved dramatically as a result of pain relief and assistance with gait training. This case is unique for several reasons. First, it is rare for transient osteoporosis associated with pregnancy to involve both hip joints, and it rarely involves the knee. Second, this is the first reported case of pain management of transient osteoporosis associated with pregnancy being successfully treated with an antiresorptive agent. Finally, the use of alendronate in transient osteoporosis associated with pregnancy may help shorten disability by providing pain relief and decreasing the fracture risk associated with this disease.- - - - - - - - - - ranking = 10keywords = pregnancy (Clic here for more details about this article) |