Glomerular Herniation in Toxemia of Pregnancy before 18 Weeks Gestation

Abstract

Nicole Cumbo, Kylie Oppegaard, Noelle Aikman, Supreet Kaur, Julian Dupont, Suhas Patel, Arif Asif, Tushar Vachharajani, Sushil Mehandru, Aisha Masud, Jonathan McNamara, Prit Paul Singh and Walid Abboud

Presentation of preeclampsia before 18 weeks is rare. We present a case of severe preeclampsia manifesting at 18 weeks gestation, notable with concurrent renal and optic changes. Beyond the typical kidney histological features of toxemia of pregnancy, the kidney biopsy revealed a distinctive histopathological finding-herniation of the glomerular tuft into the proximal tubule. This finding is rare with only a few cases reported in the literature. We present our findings for the early identification of preeclampsia. Additionally, our case exhibited severe retinal edema on fundoscopy, also offering a potential avenue for improving early detection. These insights are crucial for further exploration and understanding of these unique aspects of early preeclampsia just prior to retinal detachment.

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