How to distinguish active SLE nephritis from preeclampsia?
Preeclampsia (formerly known as toxemia) typically occurs in late pregnancy (after 20 weeks of gestation) of primigravida. LN can occur at any time during pregnancy and is associated with active urine sediment. Since patients with SLE have an increased risk of preeclampsia at baseline, these conditions can be difficult to separate in a clinical scenario.
Interestingly in the PROMISSE study, the measurement of angiogenic factors such as placental growth factor (PGF) and soluble fms-like tyrosine kinase 1 (sFlt1) measured early in pregnancy (12–19 weeks) predicted preeclampsia (low PGF and high sFlt1).
