The use of angiogenic and antiangiogenic factors in the differential diagnosis of pre-eclampsia, antiphospholipid syndrome nephropathy and lupus nephritis

Jesus, GR de; Jesus, NR de; Levy, RA; Em, Klumb

doi:10.1177/0961203314529172

Cited by 20 publications

(22 citation statements)

References 12 publications

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“…7,8,24,55 This may be challenging as they have symptoms in common and may also coexist: women with preexisting renal disease are at higher risk of hypertensive complications during pregnancy, including preeclampsia 7,24…”

Section: Antenatal Challenge: Maternal Obstetric Complicationsmentioning

confidence: 99%

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Management of systemic lupus erythematosus during pregnancy: challenges and solutions

Knight¹,

Nelson‐Piercy²

2017

OARRR

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Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease predominantly affecting women, particularly those of childbearing age. SLE provides challenges in the prepregnancy, antenatal, intrapartum, and postpartum periods for these women, and for the medical, obstetric, and midwifery teams who provide their care. As with many medical conditions in pregnancy, the best maternal and fetal–neonatal outcomes are obtained with a planned pregnancy and a cohesive multidisciplinary approach. Effective prepregnancy risk assessment and counseling includes exploration of factors for poor pregnancy outcome, discussion of risks, and appropriate planning for pregnancy, with consideration of discussion of relative contraindications to pregnancy. In pregnancy, early referral for hospital-coordinated care, involvement of obstetricians and rheumatologists (and other specialists as required), an individual management plan, regular reviews, and early recognition of flares and complications are all important. Women are at risk of lupus flares, worsening renal impairment, onset of or worsening hypertension, preeclampsia, and/or venous thromboembolism, and miscarriage, intrauterine growth restriction, preterm delivery, and/or neonatal lupus syndrome (congenital heart block or neonatal lupus erythematosus). A cesarean section may be required in certain obstetric contexts (such as urgent preterm delivery for maternal and/or fetal well-being), but vaginal birth should be the aim for the majority of women. Postnatally, an ongoing individual management plan remains important, with neonatal management where necessary and rheumatology followup. This article explores the challenges at each stage of pregnancy, discusses the effect of SLE on pregnancy and vice versa, and reviews antirheumatic medications with the latest guidance about their use and safety in pregnancy. Such information is required to effectively and safely manage each stage of pregnancy in women with SLE.

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Section: Antenatal Challenge: Maternal Obstetric Complicationsmentioning

confidence: 99%

“… Note: Data from7,8,24,55. Abbreviations: SLE, Systemic lupus erythematosus; LFTs, liver function tests; PlGF, placental growth factor; VEGF, vascular endothelial growth factor.…”

Section: Tablementioning

confidence: 99%

Management of systemic lupus erythematosus during pregnancy: challenges and solutions

Knight¹,

Nelson‐Piercy²

2017

OARRR

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“…Placentation in the setting of preeclampsia is characterized by dysregulated angiogenic factors, decreased trophoblast invasion, and excessive inflammation at the maternal-fetal interface. [16][17][18][19] Even in the absence of preeclampsia, pregnancies complicated by either diabetes, [20][21][22][23][24] or aPL 25,26 appears associated with similar histological and biological profiles.…”

Section: Introductionmentioning

confidence: 99%

Modulation of trophoblast function by concurrent hyperglycemia and antiphospholipid antibodies is in part TLR4‐dependent

Leon-Martinez

Mulla

Han

et al. 2018

American J Rep Immunol

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“…Hence, the incorporation of angiogenic markers may help to risk stratify women with high suspicion for preeclampsia. Similarly, angiogenic markers have proved to be useful in distinguishing between confounding diagnoses, such as chronic hypertension, CKD, and lupus nephritis (12)(13)(14)(15). The potential to target sFlt as a therapy is also exciting and currently being studied using an apheresis technique (16).…”

Section: Angiogenic Factorsmentioning

confidence: 99%

Preeclampsia: Updates in Pathogenesis, Definitions, and Guidelines

Phipps

Prasanna

Brima

et al. 2016

CJASN

496

328

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Preeclampsia is becoming an increasingly common diagnosis in the developed world and remains a high cause of maternal and fetal morbidity and mortality in the developing world. Delay in childbearing in the developed world feeds into the risk factors associated with preeclampsia, which include older maternal age, obesity, and/or vascular diseases. Inadequate prenatal care partially explains the persistent high prevalence in the developing world. In this review, we begin by presenting the most recent concepts in the pathogenesis of preeclampsia. Upstream triggers of the well described angiogenic pathways, such as the heme oxygenase and hydrogen sulfide pathways, as well as the roles of autoantibodies, misfolded proteins, nitric oxide, and oxidative stress will be described. We also detail updated definitions, classification schema, and treatment targets of hypertensive disorders of pregnancy put forth by obstetric and hypertensive societies throughout the world. The shift has been made to view preeclampsia as a systemic disease with widespread endothelial damage and the potential to affect future cardiovascular diseases rather than a selflimited occurrence. At the very least, we now know that preeclampsia does not end with delivery of the placenta. We conclude by summarizing the latest strategies for prevention and treatment of preeclampsia. A better understanding of this entity will help in the care of at-risk women before delivery and for decades after.

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The use of angiogenic and antiangiogenic factors in the differential diagnosis of pre-eclampsia, antiphospholipid syndrome nephropathy and lupus nephritis

Cited by 20 publications

References 12 publications

Management of systemic lupus erythematosus during pregnancy: challenges and solutions

Management of systemic lupus erythematosus during pregnancy: challenges and solutions

Modulation of trophoblast function by concurrent hyperglycemia and antiphospholipid antibodies is in part TLR4‐dependent

Preeclampsia: Updates in Pathogenesis, Definitions, and Guidelines

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