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The disease results from the aggregation of erythrocytes infected by Plasmodium falciparum which have been shown to adhere to chondroitin sulfate A (CSA) on placental proteoglycans causing them to accumulate in the intervillous spaces of the placenta, blocking the crucial flow of nutrients from mother to embryo.

Erythrocytes that have been infected by P. falciparum express the var2CSA variant of P. falciparum Erythrocyte Membrane Protein 1 (PfEMP1) which allows the infected erythrocyte to bind to CSA on the placenta. Women who are pregnant for the first time are most susceptible to infection since they do not have immunity to Var2CSA.

Pelvic Lipomatosis

Prevalence (PMID: 1856914)

• Rare disease, only about 130 reported cases (1959-1988)
• Predominantly affects men, around half of reported cases in blacks (mostly from US)

Symptoms (PMID: 5642294/)

• Based on case reports: increased urinary frequency, recurrent urinary tract infection, low-grade fever, backache, bladder pain, mild constipation (some had no urinary tract symptoms)

Diagnosis

• CT scan: highly positioned bladder, pear-shaped bladder
• Overgrowth of normal fatty tissue in pelvis

Surgical Treatment (PMID: 31261563)

• Conservative treatment (steroids, long-term antibiotics, weight reduction, radiation therapy) proved to be ineffective
• 8 patients with PL who underwent pelvic fat mass extirpation and ureteral reimplantation at our hospital from September 2010 to March 2018
• No severe perioperative complications in all 8 patients after median follow-up time of 48.5 months