The development of atypical hemolytic uremic syndrome in the presence of HELLP syndrome
Background. Obstetric thrombotic microangiopathies (TMA) in pregnancy develop in 8–18% of all TMA cases and are one of the causes of maternal and perinatal deaths. The diagnosis in the shortest possible time and the speed of pathogenetic therapy initiation are the basic factors that influence disease outcomes and further prognosis in a woman.Mysyakov V.B., Volkova G.A., Belyaev M.V., Alimova I.N., Begunov V.A., Yumatov M.V.
Description. The paper presents a rare clinical case of a 33-year-old female patient with the malignant course of atypical hemolytic uremic syndrome (aHUS) in the presence of HELLP syndrome. It describes the clinical, anamnestic, laboratory, and instrumental data of the patient, and the features of her management and treatment.
Conclusion. Early diagnosis, timely initiation of plasmotherapy, pathogenetic treatment on 4 days after the onset of aHUS in the malignant course of aHUS with severe multiple organ dysfunction could quickly achieve not only a hematologic response, but also completely restore the function of the kidneys and other affected organs.
Keywords
obstetric thrombotic microangiopathy
HELLP syndrome
atypical hemolytic uremic syndrome
microangiopathic hemolytic anemia
thrombocytopenia
plasma exchange
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Received 14.05.2019
Accepted 21.06.2019
About the Authors
Vladimir B. Mysyakov, Doctor of Medicine, Head of the Departament of obstetrics and gynecology, Penza Institute for Further Training of Physicians.Тel.: +7 (902)352-63-89, E-mail: inmed@lenta.ru
440060, Russia, Penza, Stasova str.8A.
Gulnara A Volkova, resident of the Department of Obstetrics and Gynecology, Penza Institute for Further Training of Physicians. Тel: + 7(996) 247-47-07.
E-mail: gulnaravolkova@gmail.com
440060 Russia, Penza, Stasova str.8A.
Michail V. Belyaev, Head of the Departament of gynecology, State-financed health institution «Penza regional clinical hospital named after N.N. Burdenko».
Tel.: +7(902)207-51-45. E-mail: gynecologiburdenko@gmail.com
440026 Russia, Penza, Lermontova str., 28.
Irina N. Alimova, Head of the Center of nephrology, State-financed health institution «Penza regional clinical hospital named after N.N. Burdenko».
Tel.: +7(927)288-87-93. E-mail: irinaalimova@mail.ru
440026 Russia, Penza, Lermontova str., 28.
Viktor A. Begunov, Candidate of Medical Science, State-financed health institution «Penza regional clinical hospital named after N.N. Burdenko».
Tel.: +7(927)380-11-03. E-mail: bva59n@mail.ru
440026 Russia, Penza, Lermontova str., 28.
Michail V. Yumatov, Head of the Departament of anesthesiology and reanimation, State-financed health institution «Penza regional clinical hospital named
after N.N. Burdenko». Tel.: +7 (937)432-21-39. E-mail: mik-yumatov@yandex.ru
440026 Russia, Penza, Lermontova str., 28.
For citation: Mysyakov V.B., Volkova G.A., Belyaev M.V., Alimova I.N., Begunov V.A., Yumatov M.V. The development of atypical hemolytic uremic syndrome in the presence of HELLP syndrome.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2019; 12: 198-201.(In Russian).
https://dx.doi.org/10.18565/aig.2019.12.198-201
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