Thrombotic Microangiopathy Mediated by Complement in Postpartum Sequentially Treated With Plasmapheresis and Eculizumab

Abstract

The complement-mediated thrombotic microangiopathy (TMA), also known as atypical hemolytic uremic syndrome (aHUS), is rare and potentially fatal, presenting as TMA and dysfunction/endothelial edema secondary to diffuse disruption of a fluid phase alternating complementary pathways. We report a case of a young woman with postpartum anuric renal failure, TMA and normal levels of AD-AMTS13 with partial clinical improvement after plasmapheresis, in which treatment with eculizumab led to the complete reversal of the clinical manifestations. Our work includes a brief literature review on the diagnosis and management of TMA in puerperium.