Hypertension and Proteinuria in early Pregnancy: Preeclampsia, Acute Intermittent Porphyria or Both?

Loai Ahwal; Mohamed El-Bedewy; Timor Hassan; Ghada Aleem; kamal okasha

Nephro-Urology Monthly

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Hypertension and Proteinuria in early Pregnancy: Preeclampsia, Acute Intermittent Porphyria or Both?

Author(s):

Loai Ahwal,

Mohamed El-Bedewy,

Timor Hassan,

Ghada Aleem,

kamal okasha^1,*

1Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt

Nephro-Urology Monthly:Vol. 3, issue 2; 130-131

Published online:Apr 30, 2011

Article type:Case Report

Received:Aug 27, 2010

Accepted:Sep 24, 2010

How to Cite:Ahwal L, El-Bedewy M, Hassan T, Aleem G, okasha K. Hypertension and Proteinuria in early Pregnancy: Preeclampsia, Acute Intermittent Porphyria or Both?.Nephro-Urol Mon.2011;3(2):130-131.

Abstract

We report a case of early onset recurrent preeclampsia in a patient with positive family history of preeclampsia and a newly discovered acute intermittent porphyria. A 28 years old patient was admitted to our Clinic, due to early onset of preeclampsia in her third pregnancy. She had refractory hypertension with tachycardia, facial flush, anxiety and difficulty in breathing. During hospitalization, she reported occurrence of opalescent orange to reddish morning urine, which turned dark after a while. The dipstick test revealed positive urobilinogen in the urine. The same sample of urine was tested for porphobilinogens in the urine (by the use of Ehrlich's reagent) which were found positive and also porphyrins which were found negative; therefore, her medication was switched to a beta blocker. She decided to terminate pregnancy and this was done in the next few days by the use of anesthetics that are approved for acute intermittent porphyria. At her check up one month after delivery, her blood pressure was stabilized and the coproporphyrine, porphobilinogen and porphyrins from single void urine were all negative. In the check up 2 months after delivery, proteinuria of 0.5 g/day was still present; however, it reached to normal range (1g/day) after six months. To our knowledge, this is the first case reported in the literature where superimposed preeclampsia occurs in a patient with newly discovered acute intermittent porphyria.

Keywords

Acute intermittent porphyria

Preeclampsia

Hypertension

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Author(s):

Loai Ahwal:[PubMed][Scholar]
Mohamed El-Bedewy:[PubMed][Scholar]
Timor Hassan:[PubMed][Scholar]
Ghada Aleem:[PubMed][Scholar]
kamal okasha:[PubMed][Scholar]

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Hypertension and Proteinuria in early Pregnancy: Preeclampsia, Acute Intermittent Porphyria or Both?

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