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CASE REPORT
Recurrent case of pregnancy-induced atypical haemolytic uremic syndrome (P-aHUS)
  1. Dileep Kumar1,
  2. Mary King2,
  3. Belinda Jim1 and
  4. Anjali Acharya1
  1. 1 Medicine (Nephrology), Jacobi Medical Center / Albert Einstein College of Medicine, New York City, New York, USA
  2. 2 Obstetrics, Jacobi Medical Center, New York City, New York, USA
  1. Correspondence to Dr Dileep Kumar, dileeplakhanimd{at}gmail.com

Abstract

Pregnancy-induced atypical haemolytic uremic syndrome (P-aHUS) is a rare condition characterised by microangiopathic haemolytic anaemia, thrombocytopenia and renal failure. It accounts for approximately 7% of total HUS cases. Here, we present a case of recurrent P-aHUS in a 25-year-old Hispanic woman. Pregnancy was the clear trigger in both instances, and the disease manifested in first week of the postpartum period. Because of her significant obstetric history, a multidisciplinary approach was adopted to monitor her second pregnancy antepartum and post partum. As the patient developed recurrence of P-aHUS 4 days after her delivery, she was immediately administered eculizumab within few hours of disease manifestation. The patient normalised her haematological parameters within 1 week but sustained dialysis-requiring renal failure for a total of 6 weeks. This case highlights the advances as well as the ongoing uncertainties, especially with respect to the use of eculizumab, in this rare but morbid disease.

  • genetic screening / counselling
  • pregnancy
  • acute renal failure
  • dialysis
  • chronic renal failure

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Footnotes

  • Contributors The author contributions are as follows: DK participated in the renal care for the patient and prepared the manuscript. MK participated in the obstetric care for the patient and contributed to writing of the manuscript. BJ contributed to the care of the patient and the writing of the manuscript. AA supervised the writing and clinical care of the patient.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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