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

Orivaldo Alves Barbosa, Andre Luis Coutinho de Araujo Macedo, Manoel Pedro Guedes Guimaraes, Andre Costa Teixeira, Raissa Marques Cavalcante, Priscila Dourado Evangelista, Herivaldo Ferreira da Silva, Jose Walter Correia


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 ADAMTS13 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.

J Hematol. 2015;4(2):178-180


Thrombotic microangiopathy; Atypical hemolytic uremic syndrome; Postpartum; Eculizumab; Diseases

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