Atypical hemolytic-uremic syndrome in pregnancy: a case report

Ridzki Hastanus Sembada, L. Suromo, M. S. Harahap, H. Susanto
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Abstract

Introduction: The diagnosis of Atypical hemolytic-uremic syndrome (aHUS) is largely imprecise. Improving outcomes requires accurate diagnosis and timely management. Acute kidney damage, thrombocytopenia, and microangiopathic hemolytic anemia are all signs of aHUS. The condition is brought on by pregnancy, and in genetically susceptible women, it progresses to a terrible hemolytic illness marked by widespread endothelium damage and platelet consumption. The sickness is a potentially fatal ailment that demands quick identification and treatment.Case Presentation: Our facility provided treatment for severe anemia, thrombocytopenia, and acute renal damage in a 24-year-old G1P1A0 postpartum lady with Caesarean sectio and a HELLP syndrome suspicion. An aHUS diagnosis was later verified. The condition of the patient failed to improve in the first 24 hours after birth. Inside this presence of TMA, the patient began on daily TPE and ran in parallel prednisone medication (1 mg/kg/day). After six TPE cycles, the laboratory values began to rise.Conclusion: AHUS can be challenging to diagnose early since it frequently mimics other illnesses. To enhance results, proper diagnosis and prompt management are essential. The management strategy includes a multidisciplinary team, early plasmapheresis, and complement inhibition. To lessen the effects of aHUS, TPE should be carried out as soon as feasible on a daily basis.
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妊娠期非典型溶血尿毒综合征:病例报告
简介非典型溶血性尿毒症综合征(aHUS)的诊断在很大程度上并不精确。要改善预后,需要准确诊断和及时治疗。急性肾损伤、血小板减少和微血管病性溶血性贫血都是 aHUS 的表现。这种疾病是由妊娠引起的,在遗传易感的妇女中,它会发展成一种可怕的溶血性疾病,以广泛的内皮损伤和血小板消耗为特征。这种疾病可能致命,需要快速识别和治疗:我院曾收治过一名 24 岁的 G1P1A0 级产后女性,她患有严重贫血、血小板减少和急性肾损伤,剖腹产并怀疑患有 HELLP 综合征。后来确诊为 aHUS。患者的病情在产后 24 小时内没有好转。在出现 TMA 的情况下,患者开始每天服用 TPE,并同时服用泼尼松药物(1 毫克/千克/天)。六个TPE周期后,实验室数值开始上升:结论:AHUS 常与其他疾病相似,因此很难早期诊断。为了提高疗效,正确诊断和及时治疗至关重要。治疗策略包括多学科团队、早期血浆置换和补体抑制。为减轻 aHUS 的影响,应在可行的情况下尽早每天进行 TPE。
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