Fereshteh Saddadi
1 
, Bahareh Marghoob
1 , Neda Najafi
1 , Hounaz Akbari
1 , Mohammad Hassan Fallahkohan
2* 1 Department of Nephrology, Faculty of Medicine, Hasheminejad Kidney Center (HKC), Iran University of Medical Sciences, Tehran, Iran
2 School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
The co-occurrence of postpartum acute interstitial nephritis (AIN) and myocarditis is a rare but serious complication of pregnancy following HELLP (hemolysis, elevated liver enzymes, and low-platelet) syndrome. We present the case of a 42-year-old woman who developed HELLP syndrome at the 31st week of gestational age. Termination of pregnancy and eight sessions of plasmapheresis were conducted. The patient exhibited acute kidney injury (AKI), dyspnea, bilateral pleural effusion, and 30% left ventricular (LV) ejection fraction. The diagnosis of AIN was established by kidney biopsy, while the post-partum cardiomyopathy (PPCM) was confirmed by cardiac magnetic resonance imaging (CMRI). The AKI and PPCM, in addition to hematologic abnormalities, were successfully resolved with intravenous methylprednisolone, followed by oral prednisolone.
Implication for health policy/practice/research/medical education:
This case report presents a rare and complex clinical presentation of a postpartum patient who developed both acute interstitial nephritis and myocarditis.
Please cite this paper as: Saddadi F, Marghoob B, Najafi N, Akbari H, Fallahkohan MH. Pregnancy complicated with acute interstitial nephritis and myocarditis in postpartum period; a case report . J Nephropathol. 2025;14(3):e27591. DOI: 10.34172/jnp.2025.27591.