دورية أكاديمية
Adverse outcomes in obstetric-atypical haemolytic uraemic syndrome: a case series analysis.
| العنوان: | Adverse outcomes in obstetric-atypical haemolytic uraemic syndrome: a case series analysis. |
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| المؤلفون: | Kozlovskaya NL; a Department of Internal Medicine and Occupational Medicine , I.M. Sechenov First Moscow State Medical University , Moscow , Russia., Korotchaeva YV; a Department of Internal Medicine and Occupational Medicine , I.M. Sechenov First Moscow State Medical University , Moscow , Russia., Bobrova LA; a Department of Internal Medicine and Occupational Medicine , I.M. Sechenov First Moscow State Medical University , Moscow , Russia. |
| المصدر: | The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2019 Sep; Vol. 32 (17), pp. 2853-2859. Date of Electronic Publication: 2018 Apr 01. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Informa Healthcare Country of Publication: England NLM ID: 101136916 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1476-4954 (Electronic) Linking ISSN: 14764954 NLM ISO Abbreviation: J Matern Fetal Neonatal Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: London : Informa Healthcare Original Publication: Boca Raton : Parthenon Pub. Group, c2002- |
| مواضيع طبية MeSH: | Atypical Hemolytic Uremic Syndrome/*mortality , Multiple Organ Failure/*etiology , Pregnancy Complications/*mortality, Acute Kidney Injury/etiology ; Acute Kidney Injury/mortality ; Adult ; Antibodies, Monoclonal, Humanized/therapeutic use ; Atypical Hemolytic Uremic Syndrome/blood ; Atypical Hemolytic Uremic Syndrome/diagnosis ; Atypical Hemolytic Uremic Syndrome/drug therapy ; Complement Inactivating Agents/therapeutic use ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Multiple Organ Failure/mortality ; Perinatal Death ; Pregnancy ; Pregnancy Complications/blood ; Pregnancy Complications/diagnosis ; Pregnancy Complications/drug therapy ; Young Adult |
| مستخلص: | Objective: The aim of this case series is to raise awareness of obstetric-related atypical haemolytic uraemic syndrome (aHUS) amongst obstetricians and gynaecologists. Study design: Data from 20 consecutive patients, aged 19-38, with obstetric-aHUS manifestation during or immediately after pregnancy are reported. Patients were diagnosed and treatment was initiated between 2012 and 2016. Results: Presentation of aHUS was mainly preceded by preeclampsia and/or haemolysis, elevated liver enzymes and low platelet count syndrome, other obstetric complications, or by diarrhoea. Thrombotic microangiopathy (TMA) was evident in all patients with signs of microangiopathic haemolysis (sharp decline in haemoglobin; mean 67 g/L), elevated lactate dehydrogenase (LDH; mean 2953.1 U/L), schistocytosis, thrombocytopenia (mean platelet count 52.5 × 10 9 /µL), and acute kidney injury (AKI) (hypercreatininaemia, mean 456.4 µmol/L; oliguria or anuria). The majority of patients (80%) initially presented with arterial hypertension. Diagnosis of obstetric-aHUS was complicated, as multiple organs were affected. Time taken to make the diagnosis of aHUS delayed the initiation of fresh-frozen plasma infusions and plasma exchange (80% of patients) and subsequent eculizumab treatment (40% of patients). Maternal mortality was high (35%) as was foetal mortality (25%). Conclusions: Obstetric-aHUS is a serious condition characterized by multiple organ failure (MOF) and a high mortality rate. Presentation of obstetric-aHUS is preceded by various precipitating factors, suggesting pregnancy complications, and not the pregnancy per se , often induce aHUS in women with a genetic predisposition to its development. A delay in the correct diagnosis and initiation of the most effective treatment can have serious consequences, reinforcing the need to raise awareness of obstetric-aHUS. |
| فهرسة مساهمة: | Keywords: Atypical haemolytic uraemic syndrome; HELLP syndrome; preeclampsia; pregnancy; thrombotic microangiopathy |
| المشرفين على المادة: | 0 (Antibodies, Monoclonal, Humanized) 0 (Complement Inactivating Agents) A3ULP0F556 (eculizumab) |
| تواريخ الأحداث: | Date Created: 20180403 Date Completed: 20191224 Latest Revision: 20191224 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1080/14767058.2018.1450381 |
| PMID: | 29606012 |
| قاعدة البيانات: | MEDLINE |
PDF full text from Publisher | تدمد: | 1476-4954 |
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| DOI: | 10.1080/14767058.2018.1450381 |