재발성 산후 용혈성 요독 증후군 1예
A case of recurrent postpartum hemolytic uremic syndrome
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저자들은 첫 임신 분만 후 발생한 용혈성 요독 증후군으로 약 한달간 혈액투석 후 정상 신기능을 회복한 환자에서 5년 후 두 번째 분만 후 발생한 재발성 용혈성 요독 증후군으로 만성신부전으로 진행되어 질환 발생 12개월이 지난 현재까지 혈액투석요법 중인 환자를 경험하였기에 문헌 고찰과 함께 보고하는 바이다 .
Abstract
The hemolytic uremic syndrome (HUS) is characterized by triad of microangiopathic hemolytic anemia, thrombocytopenia, and azotemia. The major causes of this syndrome are infectious diseases, drugs, cancer, connective tissue diseases and pregnancy. The association of pregnancy with HUS is an unusual but well described event occurring typically in the postpartum period. Postpartum HUS is also a cause of acute renal failure in pregnancy. Some cases of recurrent HUS due to drugs or infection were reported. We experienced a 33-year-old woman with recurrent postpartum HUS. She had postpartum HUS 5 years ago and was recovered completely with one month treatment including hemodialysis. On this admission, she presented with hemolytic anemia, thrombocytopenia and acute renal failure after delivery. We carried out hemodialysis, plasmapheresis and other conservative management for 2 months. However, the patient's renal function was not recovered, and maintenance hemodialysis was required.(Korean J Med 62:104-108, 2002)