How nature preserves fetuses

Amyloid. 2013 Mar;20(1):56-7. doi: 10.3109/13506129.2012.746655. Epub 2012 Dec 14.

Abstract

We report on a young pregnant woman developing distal leg edema and hypoalbuminemia, who was lately diagnosed with AL amyloidosis. Fetal growth retardation led to a caesarian section in the 27th week of gestation. A live birth healthy female, 710 g weight, was admitted to the neonatal intensive care unit and survived. Thereafter the mother underwent specific chemotherapy achieving only a partial and transient response, and eventually died due to sepsis. Interestingly, amyloidotic material was found on the maternal but not on the fetal side of the placenta. Experimental data show suppression of AA amyloid formation during pregnancy and suggest a protective role of the placenta on the offspring. However, most reported cases deal with pregnant women diagnosed with AA amyloidosis associated with Familial Mediterranean Fever and describe growth retardation of the fetus, worsening renal function and preeclampsia. To the best of our knowledge, this is the first report of AL amyloidosis diagnosed in a pregnant woman. In our patient, as well as in the other reported cases, amyloidosis during pregnancy has been confirmed to be an ominous condition. Therefore mild leg edema and proteinuria during pregnancy, though a common finding, may not be innocent.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adult
  • Amyloidosis / diagnosis*
  • Amyloidosis / metabolism
  • Amyloidosis / pathology
  • Cesarean Section
  • Edema / diagnosis*
  • Edema / metabolism
  • Edema / pathology
  • Female
  • Fetal Growth Retardation / diagnosis
  • Fetal Growth Retardation / pathology
  • Fetus*
  • Gestational Age
  • Humans
  • Immunoglobulin Light-chain Amyloidosis
  • Maternal Death
  • Placenta / metabolism
  • Placenta / pathology
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / metabolism
  • Pregnancy Complications / pathology
  • Serum Amyloid A Protein / metabolism

Substances

  • Serum Amyloid A Protein