Plasma antithrombin-III (AT-III) levels in 18 patients on maintenance haemodialysis were studied. AT-III was measured functionally and immunologically before and after dialysis. Simultaneous counts of platelets were made. Prior to dialysis the average AT-III levels and platelet counts were found to be within the lower part of the normal range. On paired analysis the dialysis was seen to induce small, but significant decreases in AT-III levels and platelet counts. A positive linear correlation was found between levels of functionally and immunologically determined AT-III. Replacement of the intravenous application of heparin with an administration of low-dose, subcutaneous heparin is suggested.

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Postpartum haemolytic-uraemic syndrome successfully treated with antithrombin III Since first described in 1966 the acute postpartum haemolyticuraemic syndrome (HUS) has been reported in over 40 cases by various authors.' In view of the poor prognosis despite treatment with dialysis, immunosuppression and heparin, streptokinase, dipyridamol, acetylsalicylic acid, or corticosteroids, alone or combined, we report a case in which treatment with a concentrate of antithrombin III (AT-III) appeared to cure the haemolytic anaemia and the thrombocytopenia rapidly, normalise kidney function within a few days, and prevent irreversible kidney damage. Case report A 34-year-old primipara was admitted to hospital in the eighth month of pregnancy because of a slightly raised blood pressure (150/100 mm Hg) and

A 34-year-old woman with a family history of pregnancy-associated thrombotic disease developed pre-eclampsia in her 8th month of pregnancy. A severe haemolytic-uraemic syndrome (HUS) developed within 24 h after spontaneous delivery. Because the plasma antithrombin-IΠ (AT-III) was only 15% of the normal concentration, an AT-III concentrate was given intravenously. When the normal level of plasma AT-III was reached, the clinical and biochemical signs of the syndrome disappeared. Renal function and biopsy were normal within 10 days. Because complete recovery is unusual in patients with post partum HUS and no previous reports have described a rapid recovery, the case reported here suggests that infusion of an AT-III concentrate should be tried when plasma AT-IIIis significantly decreased.