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Postpartum hemolytic uremic syndrome in a 17-year-old Filipina primigravid

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Abstract

A 17-year-old Filipina primigravid developed acute renal failure secondary to hemolytic uremic syndrome (HUS) after undergoing emergency cesarean section for severe pre-eclampsia and abruptio placenta. She underwent hemodialysis with concurrent infusions of fresh-frozen plasma and packed red cells for 5 weeks. Renal biopsy revealed findings consistent with HUS with glomerular crescents. She received three doses of pulse methylprednisolone followed by oral prednisone. Renal function improved 5 weeks after the onset of HUS. The pathogenesis, differential diagnosis, and treatment options of postpartum HUS are discussed.

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References

  1. Robson JS, Martin AM, Ruckley VA, MacDonald MK (1968) Irreversible post partum renal failure. A new syndrome. QJ Med 37:423

    CAS  Google Scholar 

  2. Dashe JS, Ramin SM, Cunnigham FG (1998) The long-term consequences of thrombotic microangiopathy (thrombotic thrombocytopenic purpura and hemolytic uremic syndrome) in pregnancy. Obstet Gynecol 91:662–668

    CAS  PubMed  Google Scholar 

  3. Ribeiro FM, Rocha E, Maccariello E, Caldas ML, Gomes MV, Lugon JR (1997) Early gestational hemolytic uremic syndrome: case report and review of literature. Ren Fail 19:475–479

    CAS  PubMed  Google Scholar 

  4. Sibai BM, Kustermann L, Velasco J (1994) Current understanding of severe preeclampsia, pregnancy associated hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, hemolysis, elevated liver enzymes, and low platelet syndrome, and postpartum acute renal failure: different clinical syndromes or just different names? Curr Opin Nephrol Hypertens 3:436–445

    Google Scholar 

  5. Furlan M, Lammle B (2001) Aetiology and pathogenesis of thrombotic thrombocytopenic purpura and haemolytic uraemic syndrome: the role of von Willebrand factor-cleaving protease. Best Pract Res Clin Haematol 14:437–454

    Article  CAS  PubMed  Google Scholar 

  6. Richards A, Buddles MR, Donne RL, Kaplan BS, Kirk E, Venning MC, Tielemans CL, Goodship JA, Goodship TH (2001) Factor H mutations in hemolytic uremic syndrome cluster in exons 18–20, a domain important for host cell recognition. Am J Hum Genet 68:485–490

    Google Scholar 

  7. Chart H, Perry NT, Cheasty T, Wright PA (2002) The kinetics of antibody production to antigens of Escherichia coli O157 in a pregnant woman with haemolytic uraemic syndrome. J Med Microbiol 51:522–525

    CAS  PubMed  Google Scholar 

  8. Egerman RS, Sibai BM (1999) Imitators of pre-eclampsia and eclampsia. Clin Obstet Gynecol 42:551–559

    Article  CAS  PubMed  Google Scholar 

  9. Kaplan B, Proesman W (1987) The hemolytic uremic syndrome of childhood and its variants. Semin Hematol 24:148–160

    CAS  PubMed  Google Scholar 

  10. Bell WR, Braine HG, Ness PM, Kickler TS (1991) Improved survival in thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. N Engl J Med 325:398–403

    Google Scholar 

  11. First MR, Pollak VE (1988) Pregnancy and renal disease. In: Schrier RW, Gottschalk CW (eds) Diseases of the kidney, 4th edn. Little Brown, Boston, p 2550

  12. Churg J, Goldstein MH, Bernstein J (1989) Thrombotic microangiopathy including hemolytic uremic syndrome, thrombotic thrombocytopenic purpura and postpartum renal failure. In: Tischer CC, Brener BM (eds) Renal pathology with clinical and functional correlations. Lippincott Williams and Wilkins, Philadelphia, p 1091

  13. Esplin MS, Branch DW (1999) Diagnosis and management of thrombotic microangiopathies during pregnancy. Clin Obstet Gynecol 42:360–365

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Francisco E. Anacleto.

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Anacleto, F.E., Cifra, C.L. & Elises, J.S. Postpartum hemolytic uremic syndrome in a 17-year-old Filipina primigravid. Pediatr Nephrol 18, 1283–1285 (2003). https://doi.org/10.1007/s00467-003-1261-7

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  • DOI: https://doi.org/10.1007/s00467-003-1261-7

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