Atypical Presentation of Pregnancy-Related Hemolytic Uremic Syndrome

Salim Baghli, Catherine Abendroth, Umar Farooq, Jennifer Schaub

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)451-456
Number of pages6
JournalAmerican Journal of Kidney Diseases
Volume72
Issue number3
DOIs
StatePublished - Sep 1 2018

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Thrombotic Microangiopathies
Hemolytic-Uremic Syndrome
Eclampsia
Pre-Eclampsia
Thrombocytopenia
Pregnancy
Postpartum Period
Complement Membrane Attack Complex
Hemolytic Anemia
Hemolysis
Acute Kidney Injury
Renal Insufficiency
Teaching
Blood Platelets
Mutation
Liver
Enzymes

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

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Atypical Presentation of Pregnancy-Related Hemolytic Uremic Syndrome. / Baghli, Salim; Abendroth, Catherine; Farooq, Umar; Schaub, Jennifer.

In: American Journal of Kidney Diseases, Vol. 72, No. 3, 01.09.2018, p. 451-456.

Research output: Contribution to journalArticle

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