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Psoriatic Nephropathy Nearly Killed Her Baby
from Christy D.

Hi Ed.  I'm sitting in the Manchester UK airport right now. I'm headed for  the first polishing trials tomorrow in Wales where we're going to make our first attempt at manufacturing these big telescope mirrors.  [Read Enbrel Works for FlakeHQ’s Resident Astronomer.

On the psoriasis front, I've been learning a lot about our disease the past few months. I had a terrible flare partway through my pregnancy and went back on Enbrel in March. Turns out perhaps I should have stayed on it the whole time!

My OB did a simple urine protein test with each visit and in mid-March mine came back positive. So I was sent for further testing which showed my kidneys were losing huge amounts of protein and were functioning very poorly. So I was sent to a nephrologist who ordered a large battery of tests and set me up for an appointment with a high-risk pregnancy expert, since I was still only 31 weeks along.

The day before my appointment, I noticed the baby had not moved all day. So I called the OB and asked if I could stop by on the way home. I did, and they could find no heartbeat. I was immediately admitted to the hospital and another attempt was made with a sensitive monitor — a very slow weak heartbeat was found. I had an immediate C-section.

Baby Nathan was born not breathing and had an Apgar score of 2 [scores of 7-8 are normal]. He went straight to the NICU and onto a ventilator. He weighed in at 3 lb 3 oz.

My OB and I began a search to try to figure out what had happened. When I had the C-section, my blood pressure was 220/110 — I had developed a very sudden severe case of pre-eclampsia. But that doesn't happen without a cause.

I was sent back to the nephrologist to find my kidneys still weren't doing well. After another battery of tests, she believes I have psoriatic nephropathy — inflammation and damage to the kidneys caused by the same mechanism as psoriatic arthritis. My kidneys lose protein rather than keeping it in the bloodstream so both I and baby were malnourished.

Nathan was discharged on April 25 and is a very happy healthy baby. This summer, my nephrologist and I are experimenting with a large dose of Enbrel to see if that will ease my kidney symptoms. I have been sternly warned by all the doctors not to have another baby, since Nathan was within hours of being stillborn.

So yet another facet to the psoriasis struggle — maybe someday our condition will be taken seriously and not just considered ‘dry skin!’

Hope you are doing well. -Christy D.

*****

Ed’s Response:  When I first read your email, Christy, I stopped breathing at the 5th paragraph and didn’t start again until the eighth.  I did not think astronomers were supposed to have such drama in their lives!  Thankfully yours turned out all right.  Whew!

I had not heard of “psoriatic nephropathy.”  Of course, as a diabetic, I had heard about nephropathy (kidney failure).  I suppose the expression, “psoriatic nephropathy,” lends a probable cause to the kidney failure — specifically, inflammation caused by the same mechanism that causes PA.  I’d be interested in hearing from anyone else who has been diagnosed with, or knows about, psoriatic nephropathy.

Sharing your story with us, Christy, will hopefully contribute to the cause you so eloquently described: “Someday our condition will be taken seriously and not just considered ‘dry skin!’” 

Thanks, and please give baby Nathan a kiss for all of us.  -Ed

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