Pregnancy-associated atypical hemolytic uremic syndrome (P-aHUS) is a rare disease. There are only few reports in the literature, and most are in the puerperium period. It is a thrombotic microangiopathy (TMA) characterized for microangiopathic hemolytic anemia, thrombocytopenia, and renal dysfunction. We report the case of a pregnant patient at 26.3 gestation weeks, who developed clinical features of TMA, neurological alterations, and septic shock; then after fetus and placental delivery, no clinical improvement was observed; a diagnostic protocol was performed due to suspicion of P-aHUS, showing improvement after the plasma exchange sessions and eculizumab. We present here a brief review of the case since it is an entity that needs to be suspected during pregnancy when TMA features and requires an immediate diagnosis to provide timely treatment.
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http://dx.doi.org/10.1111/jog.15958 | DOI Listing |
Res Pract Thromb Haemost
November 2024
Faculty of Medicine, Tel Aviv University, Ramat-Aviv, Israel.
Background: Postpartum hemorrhage is considered a risk factor for pregnancy-associated complement-mediated hemolytic uremic syndrome (CM-HUS; previously known as atypical hemolytic uremic syndrome) but has not been systematically studied.
Objectives: To systematically examine the role of postpartum hemorrhage in precipitating CM-HUS and to describe the characteristics of postpartum hemorrhage-associated CM-HUS, its prognosis and recommended management.
Methods: A systematic review of individual participant data from case series and reports in addition to a case series from our institution.
Cureus
September 2024
Internal Medicine, Carle Foundation Hospital, Urbana, USA.
Spontaneous coronary artery dissection (SCAD) is an uncommon form of non-atherosclerotic coronary artery disease, characterized by a sudden tear in coronary artery layers. Pregnancy-associated SCAD (P-SCAD) is a rare variant occurring during pregnancy or postpartum. We present a case of P-SCAD in a 31-year-old postpartum female who experienced generalized tonic-clonic seizures along with ventricular fibrillation.
View Article and Find Full Text PDFClin Exp Optom
October 2024
School of Nursing, University of Tasmania, Hobart, Tasmania, Australia.
Pregnancy introduces a multitude of changes in the body, including hormonal fluctuations and metabolic changes, which can lead to atypical ocular signs and symptoms. Ocular manifestations range from fluctuations in vision, to microstructural changes in the retina and choroid, to dry eye disease. This narrative review highlights the range of pregnancy-related effects on the eye and vision that are likely to present in the context of routine eyecare.
View Article and Find Full Text PDFAdv Lab Med
September 2024
Servicio de Medicina Intensiva, Hospital Universitario Río Hortega, Valladolid, Castilla y León, Spain.
Kidney Int Rep
April 2024
KRH Klinikum Mitte-Location Siloah, Hannover, Germany.
Introduction: In pregnancy-related atypical hemolytic uremic syndrome (p-aHUS), transferring recommendations for treatment decisions from nonpregnant cohorts with thrombotic microangiopathy (TMA) is difficult. Although potential causes of p-aHUS may be unrelated to inherent complement defects, peripartal complications such as postpartum hemorrhage (PPH) or (pre)eclampsia or Hemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome may be unrecognized drivers of complement activation.
Methods: To evaluate diagnostic and therapeutic decisions in the practical real-life setting, we conducted an analysis of a cohort of 40 patients from 3 German academic hospitals with a diagnosis of p-aHUS, stratified by the presence ( = 25) or absence ( = 15) of PPH.
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