Skip to main content
PMC home page
British Medical Journal logoLink to British Medical Journal
. 1974 Mar 16;1(5906):473–476. doi: 10.1136/bmj.1.5906.473

Immunofluorescent Studies in Renal Biopsies in Pre-eclampsia

O M Petrucco, N M Thomson, J R Lawrence, M W Weldon
PMCID: PMC1633514  PMID: 4593706

Abstract

Renal biopsies were performed on 11 patients considered clinically and histologically to have pre-eclampsia. Immunofluorescent studies with fluorescein-labelled anti-IgG, IgA, IgM, and IgE complement, albumin, fibrin, and fibrinogen were carried out on the tissue obtained. Significant correlation was obtained between the clinical severity of the disease and the density and pattern of IgM and IgG deposition. Complement was found in glomeruli in severe cases, while complement deposition in the walls of afferent and efferent arterioles was a constant finding. These findings support the concept that an immunological mechanism may be responsible for the renal lesions in pre-eclampsia. If immunity does play a part in the pathogenesis of pre-eclampsia, possible mechanisms include the involvement of histocompatibility antigens and cross-reactivity of fetal and maternal tissues. Renal fibrin deposition in pre-eclampsia may be secondary to an immune process, an occurrence well-described in other forms of glomerulonephritis in man and other species.

Full text

PDF
474

Images in this article

474FIG. 1
on p.474
475FIG. 2
on p.475
475FIG. 3
on p.475
475FIG. 4
on p.475

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bonnar J., McNicol G. P., Douglas A. S. Coagulation and fibrinolytic systems in pre-eclampsia and eclampsia. Br Med J. 1971 Apr 3;2(5752):12–16. doi: 10.1136/bmj.2.5752.12. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Brain M. C., Kuah K. B., Dixon H. G. Heparin treatment of haemolysis and thrombocytopenia in pre-eclampsia. Report of a case and a review of the literature. J Obstet Gynaecol Br Commonw. 1967 Oct;74(5):702–711. doi: 10.1111/j.1471-0528.1967.tb03784.x. [DOI] [PubMed] [Google Scholar]
  3. Brown J. J., Davies D. L., Doak P. B., Lever A. F., Robertson J. I., Trust P. Plasma renin concentration in the hypertensive diseases of pregnancy. J Obstet Gynaecol Br Commonw. 1966 Jun;73(3):410–417. doi: 10.1111/j.1471-0528.1966.tb05181.x. [DOI] [PubMed] [Google Scholar]
  4. Brown L. J., Stalker A. L. Experimental defibrination. 3. The maternal and foetal microcirculation following placental separation or trauma. Microvasc Res. 1969 Oct;1(4):403–409. doi: 10.1016/0026-2862(69)90018-1. [DOI] [PubMed] [Google Scholar]
  5. Busch G. J., Reynolds E. S., Galvanek E. G., Braun W. E., Dammin G. J. Human renal allografts. The role of vascular injury in early graft failure. Medicine (Baltimore) 1971 Jan;50(1):29–83. [PubMed] [Google Scholar]
  6. Chesley L. C., Annitto J. E., Cosgrove R. A. The familial factor in toxemia of pregnancy. Obstet Gynecol. 1968 Sep;32(3):303–311. [PubMed] [Google Scholar]
  7. Churg J., Koffler D., Paronetto F., Rorat E., Barnett R. N. Hemolytic uremic syndrome as a cause of postpartum renal failure. Am J Obstet Gynecol. 1970 Sep 15;108(2):253–261. doi: 10.1016/0002-9378(70)90307-8. [DOI] [PubMed] [Google Scholar]
  8. DIXON H. G., ROBERTSON W. B. Vascular changes in the placental bed. Pathol Microbiol (Basel) 1961;24:622–629. doi: 10.1159/000161171. [DOI] [PubMed] [Google Scholar]
  9. Experimental rubella. Lancet. 1969 Feb 15;1(7590):357–358. [PubMed] [Google Scholar]
  10. Howie P. W., Prentice C. R., McNicol G. P. Coagulation, fibrinolysis and platelet function in pre-eclampsia, essential hypertension and placental insufficiency. J Obstet Gynaecol Br Commonw. 1971 Nov;78(11):992–1003. doi: 10.1111/j.1471-0528.1971.tb00216.x. [DOI] [PubMed] [Google Scholar]
  11. MCKAY D. G., DEBACALAO E. B., SEDLIS A. PLATELET ADHESIVENESS IN TOXEMIA OF PREGNANCY. Am J Obstet Gynecol. 1964 Dec 15;90:1315–1318. doi: 10.1016/0002-9378(64)90854-3. [DOI] [PubMed] [Google Scholar]
  12. MORRIS R. H., VASSALLI P., BELLER F. K., MCCLUSKEY R. T. IMMUNOFLUORESCENT STUDIES OF RENAL BIOPSIES IN THE DIAGNOSIS OF TOXEMIA OF PREGNANCY. Obstet Gynecol. 1964 Jul;24:32–46. [PubMed] [Google Scholar]
  13. McKAY D. G., MERRILL S. J., WEINER A. E., HERTIG A. T., REID D. E. The pathologic anatomy of eclampsia, bilateral renal cortical necrosis, pituitary necrosis, and other acute fatal complications of pregnancy, and its possible relationship to the generalized Shwartzman phenomenon. Am J Obstet Gynecol. 1953 Sep;66(3):507–539. doi: 10.1016/0002-9378(53)90068-4. [DOI] [PubMed] [Google Scholar]
  14. POLLAK V. E., NETTLES J. B. The kidney in toxemia of pregnancy: a clinical and pathologic study based on renal biopsies. Medicine (Baltimore) 1960 Dec;39:469–526. doi: 10.1097/00005792-196012000-00002. [DOI] [PubMed] [Google Scholar]
  15. POLLAK V. E., PIRANI C. L., KARK R. M., MUEHRCKE R. C., FREDA V. C., NETTLES J. B. Reversible glomerular lesions in toxaemia of pregnancy. Lancet. 1956 Jul 14;271(6933):59–62. doi: 10.1016/s0140-6736(56)90424-x. [DOI] [PubMed] [Google Scholar]
  16. Robertson W. B., Brosens I., Dixon H. G. The pathological response of the vessels of the placental bed to hypertensive pregnancy. J Pathol Bacteriol. 1967 Apr;93(2):581–592. doi: 10.1002/path.1700930219. [DOI] [PubMed] [Google Scholar]
  17. SPARGO B., McCARTNEY C. P., WINEMILLER R. Glomerular capillary endotheliosis in toxemia of pregnancy. Arch Pathol. 1959 Dec;68:593–599. [PubMed] [Google Scholar]
  18. STEBLAY R. W. Localization in human kidney of antibodies formed in sheep against human placenta. J Immunol. 1962 Apr;88:434–442. [PubMed] [Google Scholar]
  19. Sims E. A. Pre-eclampsia and related complications of pregnancy. Am J Obstet Gynecol. 1970 May 1;107(1):154–181. doi: 10.1016/s0002-9378(16)33904-7. [DOI] [PubMed] [Google Scholar]
  20. Terasaki P. I., Mickey M. R., Yamazaki J. N., Vredevoe D. Maternal-fetal incompatibility. I. Incidence of HL-A antibodies and possible association with congenital anomalies. Transplantation. 1970 Jun;9(6):538–543. [PubMed] [Google Scholar]
  21. Thomson D., Paterson W. G., Smart G. E., MacDonald M. K., Robson J. S. The renal lesions of toxaemia and abruptio placentae studied by light and electron microscopy. J Obstet Gynaecol Br Commonw. 1972 Apr;79(4):311–320. doi: 10.1111/j.1471-0528.1972.tb15802.x. [DOI] [PubMed] [Google Scholar]
  22. VASSALLI P., MORRIS R. H., MCCLUSKEY R. T. THE PATHOGENIC ROLE OF FIBRIN DEPOSITION IN THE GLOMERULAR LESIONS OF TOXEMIA OF PREGNANCY. J Exp Med. 1963 Sep 1;118:467–478. doi: 10.1084/jem.118.3.467. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. WILNER G., PHILLIPS L. L., MCKAY D. G. PLATELET DAMAGE IN EXPERIMENTAL TOXEMIA OF PREGNANCY. Obstet Gynecol. 1964 Feb;23:182–186. [PubMed] [Google Scholar]
  24. ZEEK P. M., ASSALI N. S. Vascular changes in the decidua associated with eclamptogenic toxemia of pregnancy. Am J Clin Pathol. 1950 Dec;20(12):1099–1109. doi: 10.1093/ajcp/20.12.1099. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES