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

Titel: Eculizumab Treatment for Postpartum HELLP Syndrome and aHUS—Case Report
Författare: Lokki, A. Inkeri; Haapio, Mikko; Heikkinen-Eloranta, Jenni
Upphovmannens organisation: Department of Bacteriology and Immunology
University of Helsinki
Helsinki University Hospital Area
TRIMM - Translational Immunology Research Program
Research Programs Unit
Department of Obstetrics and Gynecology
HUS Gynecology and Obstetrics
HUS Abdominal Center
Nefrologian yksikkö
Department of Medicine
Department of Medical and Clinical Genetics
Datum: 2020-04-03
Språk: eng
Sidantal: 7
Tillhör serie: Frontiers in Immunology
ISSN: 1664-3224
DOI: https://doi.org/10.3389/fimmu.2020.00548
Permanenta länken (URI): http://hdl.handle.net/10138/315267
Abstrakt: 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
Referentgranskad: Ja
Licens: cc_by
Användningsbegränsning: openAccess
Parallelpublicerad version: publishedVersion


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