Pregnancy associated atypical hemolytic uremic syndrome presenting with preeclampsia with HELLP syndrome and following treatment with Eculizumab

Abstract Objectives Pregnancy associated atypical hemolytic uremic syndrome (p-aHUS) is a rare condition of thrombotic microangiopathy (TMA) which causes an increase fetal and maternal morbidity mortality. It presents typically with triad microangiopathic anemia (MAHA), thrombocytopenia acute progressive renal failure. Differential diagnoses HELLP (Hemolysis, Elevated Liver enzymes, Low Platelets) syndrome, preeclampsia, thrombocytopenic purpura (TTP), disseminated intravascular coagulation (DIC) must be considered. In the following case report, presented 32-year-old, 38 weeks pregnant Caucasian woman admitted to Eberswalde Hospital signs preeclampsia Syndrome. Caesarean Section was performed due distress. Acute failure occurs shortly after successful delivery. After diagnosis p-aHUS established, patient given Eculizumab, yielded significant improvements. Case presentation A week upper right abdominal pain. laboratory examination, established performed. The follow-up examination revealed deterioration clinical experiencing dyspnea, oliguria, oedema, as well aggravation values, ranging from severe thrombocytopenia, anemia, liver injury, kidney injury. excluding other possible TMA, treatment Eculizumab administered. Clinical hemolysis functions were found improve gradually two administrations Eculizumab. discharged 20 days hospitalization significantly improved hematological values. Conclusions requires comprehensive assessment prompt diagnosis, can confounded by multiple similar differential diagnoses. Treatment outcome patient, but more studies are required decide on standardized regiment for p-aHUS.