4.7 Article

A Life-Threating Postpartum Atypical Hemolytic-Uremic Syndrome with Multiorgan Involvement

Journal

JOURNAL OF CLINICAL MEDICINE
Volume 11, Issue 23, Pages -

Publisher

MDPI
DOI: 10.3390/jcm11236957

Keywords

atypical Hemolytic Uremic Syndrome; postpartum; abruptio placenta; thrombotic microangiopathies

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This case report emphasizes the importance of promptly diagnosing and treating atypical hemolytic uremic syndrome in pregnant patients, as it can be life-threatening and lead to permanent renal failure.
Atypical Hemolytic Uremic Syndrome is a very rare condition that can be triggered in predisposed patients. It can remain undiagnosed and can result in a life-threatening event or permanent renal failure. We report a case of a 36-year-old pregnant woman who developed atypical hemolytic uremic syndrome postpartum. She underwent an emergency caesarean section due to abruptio placenta, and she developed biochemical alterations suggestive of a thrombotic microangiopathy. Due to worsening of renal function after plasma exchange therapy, we decided to start therapy with eculizumab. Therapy was carried out with a weekly dose of 900 mg IV for five weeks. An improvement of clinical and biochemical parameters was rapidly observed, and her renal function completely recovered. The therapy was continued for six months, with a dose of 1200 mg of eculizumab every two weeks. One year after discontinuation of the therapy, her blood pressure and renal function were still normal. Our case confirms that it is important to promptly identify a pregnancy-related thrombotic microangiopathy and that early therapy can be life-saving for the patient and can preserve renal function, avoiding dialysis.

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