Management of atypical uremic hemolytic syndrome in pregnant patient.

Atypical uremic haemolytic syndrome is a variant of thrombotic micro-andiopathy characterized by non-autoimmune hemolytic anemia, thrombocytopenia and acute renal failure as a result of excessive activation of the complement. Up to 60% of patients have mutations in the genes that encode the complement system. A disensing factor is required for its manifestation, including gestation. It is an entity with a high morbidity, which can decrease drastically if an early diagnosis is made and appropriate treatment is initiated. Administration of ecuilizumab has demonstrated rapid process disruption, reducing the need for extrarenal purification therapies and improving renal function and patient prognosis.

Management of atypical uremic hemolytic syndrome in pregnant patient. / Manejo de síndrome hemolítico urémico atípico en la paciente gestante.

Atypical uremic haemolytic syndrome is a variant of thrombotic micro-andiopathy characterized by non-autoimmune hemolytic anemia, thrombocytopenia and acute renal failure as a result of excessive activation of the complement. Up to 60% of patients have mutations in the genes that encode the complement system. A disensing factor is required for its manifestation, including gestation. It is an entity with a high morbidity, which can decrease drastically if an early diagnosis is made and appropriate treatment is initiated. Administration of ecuilizumab has demonstrated rapid process disruption, reducing the need for extrarenal purification therapies and improving renal function and patient prognosis.

Ceftazidime-induced thrombocytopenia. / Trombocitopenia inducida por ceftazidima.

Ceftazidime is an antibiotic belonging to the group of third generation cephalosporins, frequently used in clinical practice for its broad antibacterial spectrum. A case report is presented on a 78-year-old man who entered the intensive care unit due to respiratory failure secondary to nosocomial pneumonia in the postoperative period of a laparoscopic hepatic bisegmentectomy for a hepatocarcinoma. It required invasive mechanical ventilation and was treated with ceftazidime, developing a progressive decrease in platelet count after the onset of this drug and after re-exposure to it, not coinciding with the introduction of other drugs. The adverse reaction was reported to the Spanish pharmacosurveillance system and according to the Naranjo algorithm the causal relationship was probable. Since no case of ceftazidime-induced thrombocytopenia was found in the literature, we consider knowledge of it relevant as an adverse effect to be taken into account given its potential severity, especially when it cannot be explained by other causes.

Manejo de síndrome hemolítico urémico atípico en la paciente gestante / Management of atypical uremic hemolytic syndrome in pregnant patient

El síndrome hemolítico urémico atípico es una variante de la microangiopatía trombótica caracterizada por presentar anemia hemolítica no autoinmune, trombocitopenia y fallo renal agudo como consecuencia de una excesiva activación del Sistema del complemento. Hasta en un 60% de los pacientes presentan mutaciones en los genes que codifican el sistema del complemento. Se requiere un factor desencadenante para su manifestación, entre los que se encuentra la gestación. Es una entidad que presenta una elevada morbimortalidad, que puede disminuir de forma relevante si se realiza un diagnóstico precoz y se inicia tratamiento adecuado. La administración de eculizumab ha demostrado la interrupción rápida del proceso, con reducción de la necesidad de terapias de depuración extrarrenal y mejoría de la función renal y pronóstico de las pacientes.(AU)

Atypical uremic haemolytic syndrome is a variant of thrombotic micro-andiopathy characterized by non-autoimmune hemolytic anemia, thrombocytopenia and acute renal failure as a result of excessive activation of the complement. Up to 60% of patients have mutations in the genes that encode the complement system. A disensing factor is required for its manifestation, including gestation. It is an entity with a high morbidity, which can decrease drastically if an early diagnosis is made and appropriate treatment is initiated. Administration of ecuilizumab has demonstrated rapid process disruption, reducing the need for extrarenal purification therapies and improving renal function and patient prognosis.(AU)

[Valproate-induced hyperammonemic encephalopathy]. / Encefalopatia hiperamonemica inducida por acido valproico.

TITLE: Encefalopatia hiperamonemica inducida por acido valproico.

[Resuscitation damage control in the patient with severe trauma]. / Reanimación de control de daños en el paciente adultocon trauma grave.

Severe trauma is the principle cause of death among young people in developed countries, with the main causes being due to road traffic accidents and accidents at work. The principle cause of death in severe trauma is the massive uncontrolled loss of blood. Most of the severe traumas with a massive haemorrhage develop coagulopathy, with some controversy over what is the best treatment for this. Patients with severe trauma are complex patients; they have a high mortality, they consume a significant amount of sources and can require rapid, intensive and multidisciplinary treatment encompassed within the concept of resuscitation damage control. In this article we attempt to present a current view of the pathophysiology of severe trauma and resuscitation damage control that may be applied to these types of patients.

Radiculopatía lumbosacra severa tras un parto con analgesia epidural / No disponible

No disponible