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Case Records of the Massachusetts General Hospital
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Volume 358:275-289 January 17, 2008 Number 3
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Case 2-2008 — A 38-Year-Old Woman with Postpartum Visual Loss, Shortness of Breath, and Renal Failure
Colm C. Magee, M.D., Matthew P. Coggins, M.D., C. Stephen Foster, M.D., Victorine V. Muse, M.D., and Robert B. Colvin, M.D.

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Presentation of Case

Dr. Esperance A. Schaefer (Medicine): A 38-year-old woman was admitted to the hospital, because of blurred vision and shortness of breath, 2 weeks after a cesarean section had been performed because of preeclampsia during pregnancy.

The patient had been well until approximately 6 weeks before admission, at approximately 22 weeks' gestation, when a diagnosis of preeclampsia was made at another hospital. Seventeen days before admission, at approximately 25 weeks' gestation, acute shortness of breath and chest tightness developed, and she was admitted to the other hospital. The blood pressure was 175/105 mm Hg. Aminotransferase and uric acid levels were normal; . . . [Full Text of this Article]

Differential Diagnosis

Infections

Sarcoidosis

Systemic Lupus Erythematosus

Tubulointerstitial Nephritis Uveitis

Wegener's Granulomatosis or Microscopic Polyangiitis

Cryoglobulinemia

The Antiphospholipid Antibody Syndrome

Clinical Diagnosis

Dr. Colm C. Magee's Diagnosis

Pathological Discussion

Anatomical Diagnosis


Source Information

From the Renal Division, Brigham and Women's Hospital (C.C.M.); the Division of Cardiology (M.P.C.) and Departments of Radiology (V.V.M.) and Pathology (R.B.C.), Massachusetts General Hospital; and the Departments of Medicine (C.C.M., M.P.C.), Ophthalmology (C.S.F.), Radiology (V.V.M.), and Pathology (R.B.C.), Harvard Medical School — all in Boston; and the Immunology and Uveitis Foundation and the Massachusetts Eye Research and Surgery Institute, Cambridge, MA (C.S.F.).




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