Adverse outcomes in obstetric-atypical haemolytic uraemic syndrome: a case series analysis

Abstract

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.

Eculizumab in paroxysmal nocturnal haemoglobinuria and atypical haemolytic uraemic syndrome: 10‐year pharmacovigilance analysis

“…Information about risk mitigation measures can also be found in patient education and provider certification materials from the Risk Evaluation and Mitigation Strategy programme for eculizumab (www.solirisre ms.com). Recommendations from the US Advisory (Konar et al, 2016;Konar & Granoff, 2017;McNamara et al, 2017;O'Leary & Kimberlin, 2017), the Centers for Disease Control and Prevention suggests that consideration be given to appropriate use of antibiotic prophylaxis; all patients should be monitored for early signs of meningococcal infection. The susceptibility to develop serious infections with Neisseria species other than meningococcus was confirmed.…”

“…Historically, pregnancy has been discouraged in patients with PNH, and the management of PNH during pregnancy has been challenging because pregnant patients can have more severe intravascular haemolysis, and morbidity and mortality are higher among pregnant women with PNH versus those with PNH who are not pregnant; these risks continue to be high during the post‐partum period (Kelly et al , ). In terms of aHUS, data on pregnancy outcomes is very scarce but due to complement activation, patients have severe manifestations and poor outcomes (Huerta et al , ; Kozlovskaya et al , ). Assessment of potential risk of malignancy was also a priority even though anti‐tumour immunity is not expected to be affected in patients with late complement deficiency.…”

Update on Thrombocytopenia in Pregnancy

“…12,15,17 Indeed, pregnancy is a potent complement activator, accounting for 7% of CM-HUS cases. 30 This is an exclusion diagnosis, after ruling out TTP as well as other TMA causes. 15,17 Complement genetic testing can be performed to support the diagnosis.…”

Atypical hemolytic uremic syndrome in the Colombian Caribbean: its particular characteristics

“…When complement system activation exceeds the regulatory ability of the previously mentioned proteins, injury is produced specially in the endothelial cells of human placenta. This phenomenon leads to the potential risk of premature deliveries and fetal loss, as observed in the present study [ 4 , 18 , 19 ].…”

“…Because of the high morbidity and mortality associated with aHUS, it is crucial to have an understanding of the potential clinical manifestations of the disease and its associated laboratory findings to ensure prompt diagnosis and treatment [ 17 ]. aHUS typically is characterized by renal involvement [ 24 ]; however, medical literature is increasingly reporting extra-renal complications of the disease, including cardiovascular, neurological, pulmonary, and gastrointestinal [ 4 , 19 , 27 ]. Gastrointestinal complications of HUS are quite exclusive of Shiga-toxin-producing E. coli-associated HUS, whereas aHUS have usually mild or absent intestinal involvement [ 28 ].…”