Postpartum microangiopathic disorders: A case report and review of the literature

• Main Authors: C.H. Wessel (Author), C.E. Andreescu (Author), S. Rombout-De Weerd (Author), M.D. Levin (Author)
• Format: Book
• Published: Elsevier, 2014-07-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2214-9112; 10.1016/j.crwh.2014.08.001
• Keywords: Postpartum; TTP; TMA; ADAMTS13; HELLP; Surgery; RD1-811; Gynecology and obstetrics; RG1-991
• Source: Case Reports in Women's Health, Vol 3, Iss C, Pp 3-6 (2014)

Introduction: Thrombotic microangiopathic disorders (TMA's) consist of five overlapping disorders: severe pre-eclampsia; HELLP (haemolysis, elevated liver enzyme, and low platelet count) syndrome; thrombotic thrombocytopenic purpura (TTP); haemolytic-uremic syndrome (HUS) and systemic lupus erythematosus (SLE). Although several case reports are published on TTP during pregnancy, none of them has described TTP in the postpartum period. Case presentation: We present a case report that illustrates the clinical difficulties and uncertainties in diagnosing TTP in a peripartum period. After repeatedly borderline ADAMTS13 tests and deteriorating TMA abnormalities in the first 72 h postpartum, treatment with plasma filtration, fresh frozen plasma and prednisolone resulted in a quick clinical and laboratory response. Conclusion: Treatment for TTP should be strongly considered in case of an on-going TMA more than 72 h after delivery.