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[Postpartum hemolytic uremic syndrome: a rare entity and a treatment challenge].

Abstract
Hemolytic uremic syndrome (HUS) is a rare entity that in 7% of cases has been related to oral contraceptives, pregnancy and puerperium, In this clinical setting prognosis is worse and renal replacement therapy is usually needed. Different authors agree that plamapheresis is the treatment of choice, and has improved patient survival to 80-90%. We describe a case of a young woman that 10 days postpartum developed thrombocytopenia, microangiopathic hemolytic anemia and acute renal failure with nephrotic range proteinuria. With the suspicion of HUS she was started on plasmapheresis initially stopped due to an anaphylactic reaction to plasma and finally due to hyperhidratation with acute pulmonary edema needing mechanical ventilation. Renal biopsy confirmed the diagnosis. Clinical course was complicated with refractory hypertension and infectious complications In conclusion postpartum HUS is a rare clinical entity , that forces a differential diagnosis with hypertensive complications of pregnancy. It is associated to multiple complications difficult to handle during follow-up. Plasmapheresis treatment adds complexity to clinical care but is the only treatment of proven efficacy in order to improve survival and renal prognosis.
AuthorsE Alsina Segui, Maria Luisa Martín Conde, L Craver Hospital, E Fernández Giráldez
JournalNefrologia : publicacion oficial de la Sociedad Espanola Nefrologia (Nefrologia) Vol. 28 Issue 1 Pg. 120-1 ( 2008) ISSN: 0211-6995 [Print] Spain
Vernacular TitleSíndrome hemolítico-urémico post-parto: entidad rara de manejo complejo.
PMID18336155 (Publication Type: Case Reports, English Abstract, Letter)
Topics
  • Adult
  • Female
  • Hemolytic-Uremic Syndrome (diagnosis, therapy)
  • Humans
  • Puerperal Disorders (diagnosis, therapy)

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