Eculizumab Treatment for Postpartum HELLP Syndrome and aHUS—Case Report

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http://hdl.handle.net/10138/315267

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Lokki , A I , Haapio , M & Heikkinen-Eloranta , J 2020 , ' Eculizumab Treatment for Postpartum HELLP Syndrome and aHUS—Case Report ' , Frontiers in Immunology , vol. 11 , 548 . https://doi.org/10.3389/fimmu.2020.00548

Title: Eculizumab Treatment for Postpartum HELLP Syndrome and aHUS—Case Report
Author: Lokki, A. Inkeri; Haapio, Mikko; Heikkinen-Eloranta, Jenni
Other contributor: University of Helsinki, Department of Bacteriology and Immunology
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Gynecology and Obstetrics










Date: 2020-04-03
Language: eng
Number of pages: 7
Belongs to series: Frontiers in Immunology
ISSN: 1664-3224
DOI: https://doi.org/10.3389/fimmu.2020.00548
URI: http://hdl.handle.net/10138/315267
Abstract: Preeclampsia is a pregnancy-specific disorder affecting ca 3% of all pregnant women. Preeclampsia is the source of severe pregnancy complications. Later life consequences for mother and infant include increased risk of cardiovascular disease. Preeclampsia is caused by the dysfunction of the endothelium with subsequent activation of complement and coagulation systems. HELLP syndrome is considered to be an extreme complication of preeclampsia but it can also present independently. Diagnostic symptoms in HELLP syndrome are Hemolysis, Elevated Liver enzymes, and Low Platelets. Similar phenotype is present in thrombotic microangiopathies (TMAs) and HELLP syndrome is considered part of the TMA spectrum. Here, we present a case of severe preeclampsia and HELLP syndrome, which exacerbated rapidly and eventually led to need of intensive care, plasma exchange, and hemodialysis. The patient showed signs of hemolysis, disturbance in the coagulation, and organ damage in liver and kidneys. After comprehensive laboratory testing and supportive care, the symptoms did not subside and treatment with complement C5 inhibitor eculizumab was started. Thereafter, the patient started to recover. The patient had pregnancy-induced aHUS. Earlier initiation of eculizumab treatment may potentially shorten and mitigate the disease and hypothetically decrease future health risks of preeclamptic women.
Subject: 3123 Gynaecology and paediatrics
case report
preeclampsia
aHUS
eculizumab
HELLP
thrombotic microangiopathy
ELEVATED LIVER-ENZYMES
LOW PLATELET COUNT
THROMBOTIC MICROANGIOPATHY
COMPLEMENT ACTIVATION
ENDOTHELIAL FUNCTION
NORMAL-PREGNANCY
HEMOLYSIS
PREECLAMPSIA
WOMEN
LINK
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