A CASE OF ATYPICAL HEMOLYTIC UREMIC SYNDROME IN A PATIENT WITH PREECLAMPSIA

Hye-Ji Jeon; Hye-Sun Hyun; Mi-Ra Lee; Sl-A Choi; Yun-Sook Kim; Dong-Han Bae; Hui Jun Kim

doi:10.5468/KJOG.2011.54.10.626

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Jeon, Hyun, Lee, Choi, Kim, Bae, and Kim: A CASE OF ATYPICAL HEMOLYTIC UREMIC SYNDROME IN A PATIENT WITH PREECLAMPSIA

Case Report

Korean J Obstet Gynecol 2011;54(10):626-629.

Published online: 21 January 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.10.626

A CASE OF ATYPICAL HEMOLYTIC UREMIC SYNDROME IN A PATIENT WITH PREECLAMPSIA

Hye-Ji Jeon, MD¹, Hye-Sun Hyun, MD¹, Mi-Ra Lee, MD¹, Sl-A Choi, MD¹, Yun-Sook Kim, MD¹, Dong-Han Bae, MD¹, Hui Jun Kim, MD²

¹Department of Obstetrics and Gynecology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea

²Department of Laboratory Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea

Corresponding author: Yun-Sook Kim, MD Department of Obstetrics and Gynecology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, 23-20 Bongmyeong-dong, Cheonan 330-721, Korea Tel: +82-41-570-2150 Fax: +82-41-571-7887 E-mail: drsook@schmc.ac.kr

Received 26 June 2011 Accepted 1 August 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Atypical hemolytic uremic syndrome, Pre-eclampsia, Pregnancy

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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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