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Atypical Presentation of Pregnancy-Related Hemolytic Uremic Syndrome.
Baghli, Salim; Abendroth, Catherine; Farooq, Umar; Schaub, Jennifer A.
Affiliation
  • Baghli S; Division of Nephrology, Penn State Milton S. Hershey Medical Center, Hershey, PA.
  • Abendroth C; Department of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA.
  • Farooq U; Division of Nephrology, Penn State Milton S. Hershey Medical Center, Hershey, PA.
  • Schaub JA; Division of Nephrology, Penn State Milton S. Hershey Medical Center, Hershey, PA. Electronic address: jschaub@pennstatehealth.psu.edu.
Am J Kidney Dis ; 72(3): 451-456, 2018 09.
Article in En | MEDLINE | ID: mdl-29331477
The cause of acute kidney injury during pregnancy and in the postpartum period can be particularly challenging to diagnose, especially when it is necessary to differentiate among preeclampsia; eclampsia; hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome; and thrombotic microangiopathies (TMAs). All these disease entities can present with kidney failure, microangiopathic hemolytic anemia, and thrombocytopenia. We present a teaching case of atypical hemolytic uremic syndrome in the postpartum period in a young woman who was found to have mutations of uncertain clinical significance in the complement cascade, including in C3, CFH, and CFI. We use this as an opportunity to review the clinical presentation and pathophysiology of preeclampsia, eclampsia, and the TMAs. We focus on diagnostic challenges, especially because many patients with TMA do not present with thrombocytopenia, which can delay diagnosis. We additionally review the clinical settings in which administration of eculizumab, a C5 membrane attack complex inhibitor, is appropriate.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pregnancy Complications / Atypical Hemolytic Uremic Syndrome Limits: Adult / Female / Humans / Pregnancy Language: En Journal: Am J Kidney Dis Year: 2018 Document type: Article Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pregnancy Complications / Atypical Hemolytic Uremic Syndrome Limits: Adult / Female / Humans / Pregnancy Language: En Journal: Am J Kidney Dis Year: 2018 Document type: Article Country of publication: United States