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Hemolytic Uremic Syndrome in Pregnancy and Postpartum.
Bruel, Alexandra; Kavanagh, David; Noris, Marina; Delmas, Yahsou; Wong, Edwin K S; Bresin, Elena; Provôt, François; Brocklebank, Vicky; Mele, Caterina; Remuzzi, Giuseppe; Loirat, Chantal; Frémeaux-Bacchi, Véronique; Fakhouri, Fadi.
Afiliación
  • Bruel A; Due to the number of contributing authors, the affiliations are provided in the Supplemental Material .
Clin J Am Soc Nephrol ; 12(8): 1237-1247, 2017 Aug 07.
Article en En | MEDLINE | ID: mdl-28596415
BACKGROUND: Pregnancy is associated with various forms of thrombotic microangiopathy, including hemolytic uremic syndrome. A previous small French study suggested that pregnancy-associated hemolytic uremic syndrome was to be included in the spectrum of atypical hemolytic uremic syndrome linked to complement alternative pathway dysregulation. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We sought to retrospectively analyze the presentation, outcome, and frequency of complement alternative pathway gene variants in a larger international (France, United Kingdom, Italy) cohort of patients with pregnancy-associated hemolytic uremic syndrome. RESULTS: Eighty-seven patients with pregnancy-associated hemolytic uremic syndrome were included. Hemolytic uremic syndrome occurred mainly during the first pregnancy (58%) and in the postpartum period (76%). At diagnosis, 56 (71%) patients required dialysis. Fifty-six (78%) patients underwent plasma exchanges, 21 (41%) received plasma infusions, and four (5%) received eculizumab. During follow-up (mean duration of 7.2 years), 41 (53%) patients reached ESRD, 15 (19%) had CKD, and 18 (28%) patients experienced hemolytic uremic syndrome relapse. Twenty-four patients (27%) received a kidney transplant and a recurrence of hemolytic uremic syndrome occurred in 13 (54%) patients. Variants in complement genes were detected in 49 (56%) patients, mainly in the CFH (30%) and CFI genes (9%). CONCLUSIONS: Pregnancy-associated hemolytic uremic syndrome and atypical hemolytic uremic syndrome nonrelated to pregnancy have the same severity at onset and during follow-up and the same frequency of complement gene variants.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Complicaciones del Embarazo / Periodo Posparto Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies País/Región como asunto: Europa Idioma: En Revista: Clin J Am Soc Nephrol Asunto de la revista: NEFROLOGIA Año: 2017 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Complicaciones del Embarazo / Periodo Posparto Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies País/Región como asunto: Europa Idioma: En Revista: Clin J Am Soc Nephrol Asunto de la revista: NEFROLOGIA Año: 2017 Tipo del documento: Article