Pregnancy in patient with cirrhosis and cryoglobulinemic vasculitis
Pregnancy in patient with cirrhosis and cryoglobulinemic vasculitis
Leído
8289
Vecesse ha leído el artículo
2547
Total PDF
5742
Total HTML
Compartir estadísticas
array:21 [ "pii" => "X0211699513052677" "issn" => "02116995" "doi" => "10.3265/Nefrologia.pre2013.Apr.11914" "estado" => "S300" "fechaPublicacion" => "2013-07-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2013;33:613-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4507 "formatos" => array:3 [ "EPUB" => 301 "HTML" => 3557 "PDF" => 649 ] ] "Traduccion" => array:1 [ "en" => array:17 [ "pii" => "X2013251413052674" "issn" => "20132514" "doi" => "10.3265/Nefrologia.pre2013.Apr.11914" "estado" => "S300" "fechaPublicacion" => "2013-07-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2013;33:613-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3576 "formatos" => array:3 [ "EPUB" => 298 "HTML" => 2689 "PDF" => 589 ] ] "en" => array:8 [ "idiomaDefecto" => true "titulo" => "Pregnancy in patient with cirrhosis and cryoglobulinemic vasculitis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "613" "paginaFinal" => "614" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Gioacchino Li Cavoli, Carlo Giammarresi, Calogera Tortorici, Luisa Bono, Angelo Ferrantelli, Ugo Rotolo" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Gioacchino" "apellidos" => "Li Cavoli" ] 1 => array:2 [ "nombre" => "Carlo" "apellidos" => "Giammarresi" ] 2 => array:2 [ "nombre" => "Calogera" "apellidos" => "Tortorici" ] 3 => array:2 [ "nombre" => "Luisa" "apellidos" => "Bono" ] 4 => array:2 [ "nombre" => "Angelo" "apellidos" => "Ferrantelli" ] 5 => array:2 [ "nombre" => "Ugo" "apellidos" => "Rotolo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X0211699513052677" "doi" => "10.3265/Nefrologia.pre2013.Apr.11914" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699513052677?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413052674?idApp=UINPBA000064" "url" => "/20132514/0000003300000004/v0_201502091629/X2013251413052674/v0_201502091630/en/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "X0211699513052669" "issn" => "02116995" "doi" => "10.3265/Nefrologia.pre2013.Apr.11922" "estado" => "S300" "fechaPublicacion" => "2013-07-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2013;33:614-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 7543 "formatos" => array:3 [ "EPUB" => 279 "HTML" => 6573 "PDF" => 691 ] ] "es" => array:9 [ "idiomaDefecto" => true "titulo" => "Hipocalcemia severa posdenosumab" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "614" "paginaFinal" => "615" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Severe hypocalcaemia post-denosumab" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Isabel M. Martín-Baez, Raquel Blanco-García, Mario Alonso-Suárez, Cynthia Cossio-Aranibar, Laura V. Beato-Coo, Francisco Fernández-Fleming" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Isabel M." "apellidos" => "Martín-Baez" ] 1 => array:2 [ "nombre" => "Raquel" "apellidos" => "Blanco-García" ] 2 => array:2 [ "nombre" => "Mario" "apellidos" => "Alonso-Suárez" ] 3 => array:2 [ "nombre" => "Cynthia" "apellidos" => "Cossio-Aranibar" ] 4 => array:2 [ "nombre" => "Laura V." "apellidos" => "Beato-Coo" ] 5 => array:2 [ "nombre" => "Francisco" "apellidos" => "Fernández-Fleming" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X2013251413052666" "doi" => "10.3265/Nefrologia.pre2013.Apr.11922" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413052666?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699513052669?idApp=UINPBA000064" "url" => "/02116995/0000003300000004/v0_201502091404/X0211699513052669/v0_201502091405/es/main.assets" ] "itemAnterior" => array:17 [ "pii" => "X0211699513052685" "issn" => "02116995" "doi" => "10.3265/Nefrologia.pre2013.Feb.11847" "estado" => "S300" "fechaPublicacion" => "2013-07-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Nefrologia. 2013;33:612-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 7369 "formatos" => array:3 [ "EPUB" => 302 "HTML" => 6315 "PDF" => 752 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Disfunción severa de marcapasos por hiperpotasemia" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "612" "paginaFinal" => "613" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Severe dysfunction of pacemaker due to hyperkalaemia" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "copyright" => "Elsevier España" "figura" => array:1 [ 0 => array:4 [ "imagen" => "11847_19904_39446_es_11847_f1_copy1.jpg" "Alto" => 478 "Ancho" => 600 "Tamanyo" => 110173 ] ] "descripcion" => array:1 [ "es" => "Electrocardiograma de 12 derivaciones mostrando el fallo de captura (ausencia de complejos QRS tras la primera, segunda y cuarta espículas)" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Diana Faur, Pere Torguet-Escuder, Martí Vallès-Prats" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Diana" "apellidos" => "Faur" ] 1 => array:2 [ "nombre" => "Pere" "apellidos" => "Torguet-Escuder" ] 2 => array:2 [ "nombre" => "Martí" "apellidos" => "Vallès-Prats" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "X2013251413052682" "doi" => "10.3265/Nefrologia.pre2013.Feb.11847" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251413052682?idApp=UINPBA000064" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699513052685?idApp=UINPBA000064" "url" => "/02116995/0000003300000004/v0_201502091404/X0211699513052685/v0_201502091405/es/main.assets" ] "en" => array:9 [ "idiomaDefecto" => true "titulo" => "Pregnancy in patient with cirrhosis and cryoglobulinemic vasculitis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "613" "paginaFinal" => "614" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Gioacchino Li Cavoli, Carlo Giammarresi, Calogera Tortorici, Luisa Bono, Angelo Ferrantelli, Ugo Rotolo" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Gioacchino" "apellidos" => "Li Cavoli" "email" => array:1 [ 0 => "gioacchinolicavoli@libero.it" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 1 => array:3 [ "nombre" => "Carlo" "apellidos" => "Giammarresi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 2 => array:3 [ "nombre" => "Calogera" "apellidos" => "Tortorici" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 3 => array:3 [ "nombre" => "Luisa" "apellidos" => "Bono" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 4 => array:3 [ "nombre" => "Angelo" "apellidos" => "Ferrantelli" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] 5 => array:3 [ "nombre" => "Ugo" "apellidos" => "Rotolo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Division of Nephrology, Civic and Di Cristina Hospital, Palermo, Italy, " "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pregnancy in patient with cirrhosis and cryoglobulinemic vasculitis" ] ] "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">Dear Editor,</span></p><p class="elsevierStylePara">Pregnancy is a rare event in patients with cirrhosis<span class="elsevierStyleSup">1</span> and women with hepatitis have an increased risk of complications during pregnancy.<span class="elsevierStyleSup">2,3</span> There are few reports on this topic. The cryoglobulinemic vasculitis associated with HCV infection is a severe systemic disease involving the kidneys; it develops due to deposits of cryoglobulins. The course is often fatal or leads to end-stage renal disease. The disease tends to relapse. Women with this disorder rarely become pregnant and conclude successfully the pregnancy.</p><p class="elsevierStylePara">Our experience: a 30-year-old woman suffering from HCV-cirrhosis was admitted for severe peripheral edema with proteinuria 7g/day and albumin 2.3g/dL. The glomerular filtration rate was in the normal range. Renal biopsy showed a membranous-proliferative glomerulonephritis.<br></br>The patient received 1 cycle of 12 plasmapheresis associated with Mycophenolate Mofetil (MM) 2g/day and prednisone 12.5mg/day therapy. After 1 month, we observed a partial remission of proteinuria (3g/day). The MM therapy was continued. After 2 years, the patient reported amenorrhea lasting for 3 months. The beta-HCG test and U.S. scan confirmed the pregnancy. The MM was interrupted whereas prednisone therapy was maintained at 5mg/day. During pregnancy, proteinuria was always less than 2g/day and renal function was regular. The pregnancy continued without major problems. A cesarean section was performed at the thirty-sixth week of pregnancy. Laboratory tests showed: white blood cells: 3.170/mmc, Hb: 8.2g/dL. PLT: 46.000/mmc, AST: 60IU/L, ALT 33IU/L, gammaGT: 14IU/L, total bilirubine: 1.84mg/dL, total protein: 4.1g/dL, albumin: 2.16g/dL. The fetus was healthy and growth corresponded to the twenty-eighth week of pregnancy. Anti-HCV antibodies detection was negative and the child follow-up did not show any significant diseases after 3 years from birth. The patient resumed MM and prednisone therapy. One year after the child's birth, the patient showed good health with proteinuria 1g/day; she continued MM 2g/day and prednisone 5mg/day. After 18 months postpartum, proteinuria increased to 4g/day. We carried out again a cycle of six plasmapheresis, achieving a reduction of proteinuria (<1g/day). Therefore, we carried out the maintenance of MM and prednisone therapy at the same dose. Although pregnancy in patient with cirrhosis remains rare, recent improvements in the treatment of cirrhosis led to an increase in life expectancy and quality of life, making pregnancy a most frequent event. Outcomes of pregnancy in patients with cirrhosis are poorly described. Regarding neonatal well-being, there is no association between vertical transmission of HCV and gestational age at delivery or the presence of chorioamnionitis. There is no evidence demonstrating an increased risk of HCV transmission in HIV-negative women who breast feed.<span class="elsevierStyleSup">4</span> There are some reports regarding a worsening of HCV-liver disease after pregnancy.<span class="elsevierStyleSup">5</span> Regarding immunological pathology, the prognosis associated with many forms of systemic vasculitides was quite grim. Advances in this field have allowed us to focus on issues related to quality of life such as fertility, conception, and pregnancy among women with vasculitis.<span class="elsevierStyleSup">6</span> This case report shows the possibility of a favourable outcome, if the pregnancy occurs during a clinical stabilization phase of cirrhosis and vasculitis.</p><p class="elsevierStylePara"> </p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflict of interest</span></p><p class="elsevierStylePara"> </p><p class="elsevierStylePara">The authors declare that they have no conflicts of interest related to the contents of this article.</p>" "pdfFichero" => "P1-E557-S4311-A11914.pdf" "tienePdf" => true ] "idiomaDefecto" => "en" "url" => "/02116995/0000003300000004/v0_201502091404/X0211699513052677/v0_201502091405/en/main.assets" "Apartado" => array:4 [ "identificador" => "35346" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Cartas al Director - Casos clínicos breves" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02116995/0000003300000004/v0_201502091404/X0211699513052677/v0_201502091405/en/P1-E557-S4311-A11914.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699513052677?idApp=UINPBA000064" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 8 | 12 | 20 |
| 2024 Octubre | 50 | 44 | 94 |
| 2024 Septiembre | 55 | 36 | 91 |
| 2024 Agosto | 68 | 70 | 138 |
| 2024 Julio | 33 | 27 | 60 |
| 2024 Junio | 67 | 37 | 104 |
| 2024 Mayo | 43 | 41 | 84 |
| 2024 Abril | 49 | 38 | 87 |
| 2024 Marzo | 38 | 32 | 70 |
| 2024 Febrero | 37 | 40 | 77 |
| 2024 Enero | 33 | 23 | 56 |
| 2023 Diciembre | 25 | 23 | 48 |
| 2023 Noviembre | 34 | 36 | 70 |
| 2023 Octubre | 41 | 40 | 81 |
| 2023 Septiembre | 31 | 37 | 68 |
| 2023 Agosto | 33 | 29 | 62 |
| 2023 Julio | 44 | 42 | 86 |
| 2023 Junio | 46 | 25 | 71 |
| 2023 Mayo | 43 | 39 | 82 |
| 2023 Abril | 28 | 20 | 48 |
| 2023 Marzo | 30 | 25 | 55 |
| 2023 Febrero | 31 | 28 | 59 |
| 2023 Enero | 33 | 22 | 55 |
| 2022 Diciembre | 46 | 47 | 93 |
| 2022 Noviembre | 45 | 30 | 75 |
| 2022 Octubre | 44 | 52 | 96 |
| 2022 Septiembre | 39 | 39 | 78 |
| 2022 Agosto | 50 | 43 | 93 |
| 2022 Julio | 27 | 49 | 76 |
| 2022 Junio | 35 | 43 | 78 |
| 2022 Mayo | 42 | 31 | 73 |
| 2022 Abril | 33 | 54 | 87 |
| 2022 Marzo | 42 | 50 | 92 |
| 2022 Febrero | 56 | 57 | 113 |
| 2022 Enero | 33 | 35 | 68 |
| 2021 Diciembre | 31 | 46 | 77 |
| 2021 Noviembre | 41 | 41 | 82 |
| 2021 Octubre | 48 | 48 | 96 |
| 2021 Septiembre | 25 | 32 | 57 |
| 2021 Agosto | 32 | 42 | 74 |
| 2021 Julio | 45 | 34 | 79 |
| 2021 Junio | 35 | 25 | 60 |
| 2021 Mayo | 44 | 32 | 76 |
| 2021 Abril | 67 | 72 | 139 |
| 2021 Marzo | 31 | 56 | 87 |
| 2021 Febrero | 42 | 17 | 59 |
| 2021 Enero | 31 | 17 | 48 |
| 2020 Diciembre | 24 | 16 | 40 |
| 2020 Noviembre | 38 | 20 | 58 |
| 2020 Octubre | 29 | 15 | 44 |
| 2020 Septiembre | 23 | 6 | 29 |
| 2020 Agosto | 29 | 11 | 40 |
| 2020 Julio | 33 | 14 | 47 |
| 2020 Junio | 41 | 8 | 49 |
| 2020 Mayo | 23 | 12 | 35 |
| 2020 Abril | 33 | 16 | 49 |
| 2020 Marzo | 29 | 11 | 40 |
| 2020 Febrero | 39 | 21 | 60 |
| 2020 Enero | 46 | 21 | 67 |
| 2019 Diciembre | 38 | 28 | 66 |
| 2019 Noviembre | 32 | 17 | 49 |
| 2019 Octubre | 19 | 10 | 29 |
| 2019 Septiembre | 37 | 27 | 64 |
| 2019 Agosto | 32 | 17 | 49 |
| 2019 Julio | 26 | 24 | 50 |
| 2019 Junio | 39 | 14 | 53 |
| 2019 Mayo | 43 | 24 | 67 |
| 2019 Abril | 73 | 32 | 105 |
| 2019 Marzo | 37 | 21 | 58 |
| 2019 Febrero | 25 | 17 | 42 |
| 2019 Enero | 35 | 19 | 54 |
| 2018 Diciembre | 60 | 34 | 94 |
| 2018 Noviembre | 86 | 17 | 103 |
| 2018 Octubre | 67 | 15 | 82 |
| 2018 Septiembre | 46 | 17 | 63 |
| 2018 Agosto | 44 | 7 | 51 |
| 2018 Julio | 53 | 18 | 71 |
| 2018 Junio | 42 | 11 | 53 |
| 2018 Mayo | 50 | 17 | 67 |
| 2018 Abril | 58 | 13 | 71 |
| 2018 Marzo | 53 | 14 | 67 |
| 2018 Febrero | 48 | 11 | 59 |
| 2018 Enero | 48 | 14 | 62 |
| 2017 Diciembre | 44 | 7 | 51 |
| 2017 Noviembre | 37 | 11 | 48 |
| 2017 Octubre | 36 | 8 | 44 |
| 2017 Septiembre | 35 | 10 | 45 |
| 2017 Agosto | 34 | 15 | 49 |
| 2017 Julio | 36 | 9 | 45 |
| 2017 Junio | 49 | 13 | 62 |
| 2017 Mayo | 43 | 11 | 54 |
| 2017 Abril | 45 | 16 | 61 |
| 2017 Marzo | 28 | 6 | 34 |
| 2017 Febrero | 23 | 8 | 31 |
| 2017 Enero | 21 | 10 | 31 |
| 2016 Diciembre | 65 | 14 | 79 |
| 2016 Noviembre | 55 | 11 | 66 |
| 2016 Octubre | 69 | 12 | 81 |
| 2016 Septiembre | 86 | 2 | 88 |
| 2016 Agosto | 176 | 7 | 183 |
| 2016 Julio | 152 | 10 | 162 |
| 2016 Junio | 128 | 0 | 128 |
| 2016 Mayo | 131 | 0 | 131 |
| 2016 Abril | 91 | 0 | 91 |
| 2016 Marzo | 90 | 0 | 90 |
| 2016 Febrero | 109 | 0 | 109 |
| 2016 Enero | 118 | 0 | 118 |
| 2015 Diciembre | 115 | 0 | 115 |
| 2015 Noviembre | 98 | 0 | 98 |
| 2015 Octubre | 111 | 0 | 111 |
| 2015 Septiembre | 78 | 0 | 78 |
| 2015 Agosto | 79 | 0 | 79 |
| 2015 Julio | 76 | 0 | 76 |
| 2015 Junio | 55 | 0 | 55 |
| 2015 Mayo | 72 | 0 | 72 |
| 2015 Abril | 15 | 0 | 15 |
Mostrar todo
