ABSTRACT Two pregnant women who initially developed proteinuria alone followed by serious preeclampsia are presented to emphasize that there is no adequate technical term to express the period of proteinuria alone based on the current criteria of pregnancy-induced hypertension. Case 1 exhibited a urinary protein concentration of 46 mg/dL in the absence of hypertension, and abdominal pain due to placental abruption with hypertension at gestational week (GW) 29–3/7 and 29–4/7, respectively. Case 2 exhibited a urinary protein/creatinine ratio of 2.67, developed hypertension, required cesarean section, and developed posterior reversible encephalopathy syndrome at GW 28–1/7, 29–6/7, and 32–0/7, and on postpartum day 2, respectively. As women with proteinuria alone are not diagnosed as having preeclampsia and as a diagnosis of gestational proteinuria can be made only at 12 weeks postpartum, a prospective technical term applicable to the condition of proteinuria alone is needed to increase physicians’ attention to this condition.
Cite this paper
nullYamada, T. , Yamada, T. , Morikawa, M. , Takeda, M. , Nishida, R. , Akaishi, R. and Minakami, H. (2011) Isolated proteinuria as an initial sign of severe preeclampsia. Open Journal of Obstetrics and Gynecology, 1, 13-16. doi: 10.4236/ojog.2011.12003.
 Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. (2000) American Journal of Obstetrics & Gynecology, 183, S1-22.
Airoldi, J. and Weinstein, L. (2007) Clinical significance of proteinuria in pregnancy. Obstetrical & Gynecological Survey, 62, 117-124.
Morikawa, M., Yamada, T., Yamada, T., Cho, K., Yamada, H., Sakuragi, N. and Minakami, H. (2008) Pregnancy outcome of women who developed proteinuria in the absence of hypertension after mid-gestation. Journal of Perinatal Medicine, 36, 419-424.
Thomas, S.V. (1998) Neurological aspects of eclampsia. Journal of the Neurological Sciences, 155, 37-43.
Nguyen-Lam, J. and Kiernan, M.C. (2008) Acute cortical blindness due to posterior reversible encephalopathy. Journal of Clinical Neuroscience, 15, 1182-1185.
Hinchey, J., Chaves, C., Appignani, B., Breen, J., Pao, L., Wang, A., Pessin, M.S., Lamy, C., Mas, J.-L. and Caplan, L.R. (1996) A reversible leukoencephalopathy syndrome. The New England Journal of Medicine, 334, 494-500.
Holston, A.M., Qian, C., Yu, K.F., Epstein, F.H., Karumanchi and S.A., Levine, R.J. (2009) Circulating angiogenic factors in gestational proteinuria without hypertension. American Journal of Obstetrics & Gynecology, 200, e1-10.
Douglas, K.A. and Redman, C.W.G. (1994) Eclampsia in the United Kingdom. British Medical Journal, 309, 1395-1400.
Knight, M. (2007) Eclampsia in the United Kingdom 2005. British Journal of Obstetrics and Gynecology, 114, 1072-1078.
Minakami, H., Kubo, T., Takeda, S., Kawabata, M., Kobayashi, T. and Nakabayashi, M. (2009) Placental abruption, HELLP syndrome, and Eclampsia in Japan. Nippon Sanka-Fujinka Gakkai Zasshi, 61, 1559-1567.
Kullberg, G., Lindeberg, S. and Hanson, U. (2002) Eclampsia in Sweden. Hypertension in Pregnancy, 21, 13- 21. doi:10.1081/PRG-120002906