The Challenging Management of Acute Thrombotic Microangiopathy in Pregnancy.

IF 1.7 4区 医学 Q3 HEMATOLOGY Acta Haematologica Pub Date : 2023-01-01 DOI:10.1159/000527553
Bárbara Marques, Catarina Nora, Daniela Coelho, Patrícia Martinho, Teresa Fidalgo, Marília Gomes, Letícia Ribeiro, Catarina Geraldes, José Pedro Carda
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Abstract

Thrombotic microangiopathy is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ injury. Pregnancy-associated thrombotic microangiopathy is a severe disorder with a high risk of maternal mortality and poor fetal outcomes. Preeclampsia/eclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome are the most common causes, and hemolytic uremic syndrome or thrombotic thrombocytopenic purpura are rare causes. Due to overlapping clinical findings, the differential diagnosis is challenging and should be managed by a multidisciplinary team. We present a case of a 38-year-old woman at 40 weeks of second gestation, admitted with thrombotic microangiopathy being the final diagnosis not immediately clear.

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妊娠期急性血栓性微血管病的挑战性管理。
血栓性微血管病的特点是微血管病性溶血性贫血、血小板减少和终末器官损伤。妊娠相关血栓性微血管病是一种严重的疾病,具有产妇死亡率高和胎儿预后差的风险。先兆子痫/子痫和溶血,肝酶升高,低血小板综合征是最常见的原因,溶血性尿毒症综合征或血栓性血小板减少性紫癜是罕见的原因。由于重叠的临床表现,鉴别诊断是具有挑战性的,应该由一个多学科的团队管理。我们提出一个38岁的妇女在40周的第二妊娠,承认血栓性微血管病是最后的诊断不立即明确。
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来源期刊
Acta Haematologica
Acta Haematologica 医学-血液学
CiteScore
4.90
自引率
0.00%
发文量
61
审稿时长
6-12 weeks
期刊介绍: ''Acta Haematologica'' is a well-established and internationally recognized clinically-oriented journal featuring balanced, wide-ranging coverage of current hematology research. A wealth of information on such problems as anemia, leukemia, lymphoma, multiple myeloma, hereditary disorders, blood coagulation, growth factors, hematopoiesis and differentiation is contained in first-rate basic and clinical papers some of which are accompanied by editorial comments by eminent experts. These are supplemented by short state-of-the-art communications, reviews and correspondence as well as occasional special issues devoted to ‘hot topics’ in hematology. These will keep the practicing hematologist well informed of the new developments in the field.
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