Anemia with pregnancy. Endocrine Abstracts

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Anemia with pregnancy triggering causes of atypical HUS, such as non-enteric infections, viruses, drugs, systemic diseases, glomerulopathies, malignancies, transplantations, and pregnancy, have been identified [ 1234 ].

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Here we report a patient who developed atypical HUS after a hepatitis B vaccination. There was no history of fever, diarrhea, or cough. The first dose of hepatitis B vaccine was administered at birth. She had no health problems in the neonatal period and was solely breastfed.

The family history was non-contributory.

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On physical examination, the patient was in poor general condition and hypoactive with pale and icteric skin. There was no hepatosplenomegaly.

Anemia in Pregnancy

Anisocytosis, poikilocytosis, polychromasia, helmet cells, marked schistocytes, and rare platelets were observed in the peripheral blood smear, compatible with microangiopathic hemolytic anemia and thrombocytopenia.

Direct and indirect Coombs test results were negative. Urine microscopy showed numerous red blood cells.

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Microscopic examination of stool was normal and occult blood test results were negative. Her stool culture and urine culture were also negative.

Hepatitis B Vaccine-Associated Atypical Hemolytic Uremic Syndrome

Serum complement component 3 C3 and C4 levels were Prothrombin time, activated partial thromboplastin time, and fibrinogen level were within the normal ranges. Renal ultrasound showed increased echogenicity in both kidneys. As the patient had acute renal failure, thrombocytopenia, and microangiopathic anemia with pregnancy anemia, she was diagnosed with HUS. After transfusion of red blood cells, intravenous fluid therapy was initiated and intravenous furosemide was administered.

Fresh frozen plasma infusion was also started. On the third day of hospitalization, she had a seizure that was ended with a single dose of midazolam and anemia with pregnancy not recur again. Hemolysis and thrombocytopenia continued until day 8 of hospitalization and the patient required red blood cell transfusions 5 times during this period.

Anemia with pregnancy, High-Risk Pregnancy Management Options with Online Resource

She had no anemia with pregnancy. Hypertension was treated with nifedipine and enalapril. On day 9 of hospitalization, renal function, thrombocytopenia, and hemolysis began to improve, and plasma therapy was discontinued within the following 2 days.

She no longer needed dialysis.

Endocrine Abstracts

The patient was discharged in good general condition on day 16 of hospitalization anemia with pregnancy improved complete blood count, biochemical tests, and complement levels. Factor H and factor I levels were normal when measured 3 schistosomiasis disease after hospital discharge.

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The patient completed the immunization schedule except for the third dose of anemia with pregnancy B without further problems. She is currently 38 months old and has no problems.

Because infants below 6 months of age are generally breastfed pre-weaning periodexposure to Escherichia coli OH7 is less likely in this age group and, therefore, other causes of HUS should be considered in patients under 6 months of age [ 4 ].

Pregnancy Anemia as a Favorable Factor of Premature Birth

Our patient was a day-old infant with no platyhelminthes sistemul nervos central of bloody diarrhea or other infection. Her stool and urine cultures were negative anemia with pregnancy Escherichia coli and Shigella.

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Her clinical presentation was consistent with the diagnosis of atypical HUS. Our patient had clinical and laboratory findings of atypical HUS approximately 1 day after hepatitis B vaccine injection, and thus we suggest that the hepatitis B vaccine may play a triggering role for the onset of atypical HUS.

Geerdink et al. To our knowledge, ours is the second case of atypical HUS associated with hepatitis B vaccination.

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In contrast to the first reported case, we did not observe a relapse with other vaccinations. The triggering role of vaccination in the onset or relapse of atypical HUS has not been defined yet. We suggest that, compatible with the other adverse effects of vaccination, the immune-mediated activation of the anemia with pregnancy system triggers atypical HUS development. Therefore, recent history of vaccination should be examined, especially in patients without any other triggering conditions.

Pregnancy Anemia as a Favorable Factor of Premature Birth

Further reports are needed to confirm this hypothesis. References 1.

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Amirlak I, Amirlak B. Haemolytic uraemic syndrome: an overview.


Nephrology Carlton ;— Clinical practice. Eur J Pediatr. A new era in the diagnosis and treatment of atypical haemolytic uraemic syndrome.

If you are iron deficient, there may be less haemoglobin in your blood and you may look pale.

Neth J Med. Guideline for the investigation and initial therapy of diarrhea-negative hemolytic uremic syndrome. Pediatr Nephrol. Atypical hemolytic uremic syndrome in children: complement mutations and clinical characteristics.