Postpartum atypical haemolytic uremic syndrome: a rare case report

Neha Khatod, Shubhra Mukharjee, Vijay Malviya


Hemolytic uremic syndrome (HUS) is characterized by triad of microangiopathic hemolytic anaemia, Thrombocytopenia and Acute renal failure. Genetically predisposed women develop HUS and may be triggered by pregnancy. The diagnosis is challenging due to overlapping clinical features of other diseases in pregnancy. The long-term prognosis is guarded. We are presenting a case of a young primigravida who underwent emergency lower (uterine) segment caesarean section (LSCS). She developed progressive anaemia, thrombocytopenia and renal failure postoperatively. Aggressive management with plasmapheresis, blood transfusions and hemodialysis saved her life. She is currently in remission.


Hemolytic uremic syndrome, Plasmapheresis, Fresh frozen plasma, Acute renal failure

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Noris M, Remuzzi G. Atypical hemolytic-uremic syndrome. N Engl J Med. 2009;361(17):1676–87.

Saad AF, Roman J, Wyble A, Pacheco LD. Pregnancy-associated atypical hemolytic-uremic syndrome. Asia J Pharmaceut Report. 2016;6(1):e125.

Bruel A, Kavanagh D, Noris M, Delmas Y, Wong EK, Bresin E, et al. Hemolytic uremic syndrome in pregnancy and postpartum. Clinic J Americ Soc Nephrol. 2017;12(8):1237-47.

Caprioli J, Noris M, Brioschi S. Genetics of HUS: the impact of MCP, CFH, and IF mutations on clinical presentation, response to treatment, and outcome. Bloo. 2006;108(4):1267–79.

Egerman RS, Witlin AG. Thrombotic Thrombocytopenic Purpura and HUS in pregnancy: review of 11 cases AM J Obstet Gynecol 1996; 175:950.

Mc Craeka, Cines DB, Thrombotic Microangiopathy during pregnancy. Semin Hematol 1997;34:148.

Fakhouri F, Roumenina L, Provot F, Sallée M, Caillard S, Couzi L, et al. Pregnancy-associated hemolytic uremic syndrome revisited in the era of complement gene mutations. J Americ Soc Nephrol. 2010;21(5):859-67.