Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Artinger, K; Hackl, G; Schilcher, G; Eisner, F; Pollheimer, MJ; Mache, C; Weiss, EC; Eller, K; Eller, P.
The conundrum of postpartum thrombotic Microangiopathy: case report and considerations for management.
BMC Nephrol. 2019; 20(1):91-91
Doi: 10.1186/s12882-019-1286-1
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- Führende Autor*innen der Med Uni Graz
- Artinger Katharina
- Eller Philipp
- Co-Autor*innen der Med Uni Graz
- Eisner Florian
- Eller Kathrin
- Hackl Gerald
- Mache Christoph
- Pollheimer Marion
- Schilcher Gernot
- Weiss Eva Christine
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- Abstract:
- Microangiopathic hemolytic anemias and thrombocytopenias in pregnant or postpartum women constitute an interdisciplinary diagnostic and therapeutic challenge in the evaluation of thrombotic microangiopathies (TMA), where urgent care must be considered. We here report the case of a 21-year-old Somali woman, who was delivered by emergency caesarean section at 35 weeks of gestational age with acute dyspnea, placental abruption and gross edema due to severe preeclampsia/HELLP syndrome. After delivery, she developed acute kidney failure and thrombotic microangiopathy as revealed by kidney biopsy. The lack of early response to plasma exchange prompted extensive laboratory workup. Ultimately, the patient completely recovered with negative fluid balance and control of severe hypertension. This case report emphasizes the importance to differentiate between primary TMA syndromes and microangiopathic hemolytic anemias due to systemic disorders. Delayed recovery from preeclampsia/HELLP syndrome and malignant hypertension can clinically mimic primary TMA syndromes in the postpartum period.
- Find related publications in this database (Keywords)
- Thrombotic microangiopathy
- Preeclampsia
- HELLP syndrome
- Plasma exchange
- Eculizumab