Korean J Obstet Gynecol.  2011 Oct;54(10):626-629. 10.5468/KJOG.2011.54.10.626.

A case of atypical hemolytic uremic syndrome in a patient with preeclampsia

• Jeon HJ
• Hyun HS
• Lee MR
• Choi SA
• Kim YS
• Bae DH
• Kim HJ

• KMID: 1836750
• DOI: http://doi.org/10.5468/KJOG.2011.54.10.626

Abstract

Atypical hemolytic uremic syndrome (HUS) in adults is a life-threatening disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure, which is not related to Escherichia coli. This disease occurs under the condition of certain stresses, including pregnancy related disease like as preeclampsia, placental abruption, and amniotic fluid embolism. Heparin and plasma exchange has proven to be an effective treatment for HUS and it has decreased the mortality of this illness. We experienced a case of 34 weeks' pregnant woman with preeclampsia who presented with hematuria, oliguria, hemolytic anemia and thrombocytopenia. We performed emergency cesarean section due to fetal distress. After operation, she was treated with transfusion of packed red blood cell, parenteral albumin, and anticoagulant. After seven days from the operation, the sign of hematuria disappeared and her renal function partially recovered. We describe this case with a brief review of the literature.

Keyword

Atypical hemolytic uremic syndrome; Pre-eclampsia; Pregnancy

MeSH Terms

Abruptio Placentae
Acute Kidney Injury
Adult
Anemia, Hemolytic
Cesarean Section
Embolism, Amniotic Fluid
Emergencies
Erythrocytes
Escherichia coli
Female
Fetal Distress
Hematuria
Hemolytic-Uremic Syndrome
Heparin
Humans
Oliguria
Plasma Exchange
Pre-Eclampsia
Pregnancy
Pregnant Women
Thrombocytopenia
Hemolytic-Uremic Syndrome
Heparin

Figure

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  Fig. 1. The peripheral blood smear of the patient showing microcytic, hypochromatic anemia and microangiopathic hemolysis with helmet cells (thin arrow), tear drop cells (arrowhead), and burr cells (thick arrow) (Wright stain, ×400).

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