MALIGNANT NEPHROSCLEROSIS DURING PREGNANCY AND IN POSTPARTUM PERIOD (UREMIC HEMOLYTIC SYNDROME)

Histologic, immunohistologic, and ultrastructural features are presented of 2 patients with malignant nephrosclerosis during pregnancy. Primary malignant nephrosclerosis emerges as a clinical entity which can be distinguished from toxemia of pregnancy in the midtrimester and post partrum. The first description of malignant nephrosclerosis dates from 40 yr ago, but only a few cases were reported associated with pregnancy. Although disseminated intravascular coagulation seems involved, the morphology is different from that of toxemia. Malignant nephrosclerosis reveals a close similarity to the hemolytic uremic syndrome. Early diagnosis by renal biopsy and proper treatment may prevent a lethal outcome due to progressive renal failure.