Atypical hemolytic uremic syndrome after myomectomy: A case report
Atypical hemolytic uremic syndrome (aHUS) is a rare form of thrombotic microangiopathy due to inability to regulate the complement cascade, resulting in thrombocytopenia, intravascular hemolysis, and end-organ damage. Over 70% of cases are associated with mutations in complement or complement regula...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-07-01
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| Series: | Case Reports in Women's Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214911222000443 |
| _version_ | 1818507772929507328 |
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| author | Kelsey Musselman Jeffrey Laurence Cynthia Magro Pasha Rahbari Thomas Di Vitantonio Yelena Havryliuk |
| author_facet | Kelsey Musselman Jeffrey Laurence Cynthia Magro Pasha Rahbari Thomas Di Vitantonio Yelena Havryliuk |
| author_sort | Kelsey Musselman |
| collection | DOAJ |
| description | Atypical hemolytic uremic syndrome (aHUS) is a rare form of thrombotic microangiopathy due to inability to regulate the complement cascade, resulting in thrombocytopenia, intravascular hemolysis, and end-organ damage. Over 70% of cases are associated with mutations in complement or complement regulatory proteins, and some two-thirds have recognized complement-activating conditions triggering an aHUS event. We describe a case of aHUS after abdominal myomectomy in a 42-year-old woman that was managed with plasma exchange and eculizumab (an anti-C5 monoclonal antibody). The diagnosis was confirmed by biopsy of normal-appearing deltoid skin that demonstrated microvascular C5b-9 deposition, diagnostic of systemic complement pathway activation. Although extremely uncommon following gynecologic surgery, aHUS should be considered in the setting of postoperative oliguric acute kidney injury, as prompt diagnosis is necessary to prevent significant morbidity and mortality. |
| first_indexed | 2024-12-10T22:22:37Z |
| format | Article |
| id | doaj.art-d17bbffee3ce462f8012bcc0dc4bcbe8 |
| institution | Directory Open Access Journal |
| issn | 2214-9112 |
| language | English |
| last_indexed | 2024-12-10T22:22:37Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Case Reports in Women's Health |
| spelling | doaj.art-d17bbffee3ce462f8012bcc0dc4bcbe82022-12-22T01:31:17ZengElsevierCase Reports in Women's Health2214-91122022-07-0135e00424Atypical hemolytic uremic syndrome after myomectomy: A case reportKelsey Musselman0Jeffrey Laurence1Cynthia Magro2Pasha Rahbari3Thomas Di Vitantonio4Yelena Havryliuk5Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of America; Corresponding author at: Weill Cornell Medicine, Department of Obstetrics and Gynecology, 1305 York Avenue, New York, NY 10021, United States of America.Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, NY, United States of AmericaDepartment of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, United States of AmericaDepartment of Anesthesiology, Weill Cornell Medicine, New York, NY, United States of AmericaDepartment of Medicine, Weill Cornell Medicine, New York, NY, United States of AmericaDepartment of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States of AmericaAtypical hemolytic uremic syndrome (aHUS) is a rare form of thrombotic microangiopathy due to inability to regulate the complement cascade, resulting in thrombocytopenia, intravascular hemolysis, and end-organ damage. Over 70% of cases are associated with mutations in complement or complement regulatory proteins, and some two-thirds have recognized complement-activating conditions triggering an aHUS event. We describe a case of aHUS after abdominal myomectomy in a 42-year-old woman that was managed with plasma exchange and eculizumab (an anti-C5 monoclonal antibody). The diagnosis was confirmed by biopsy of normal-appearing deltoid skin that demonstrated microvascular C5b-9 deposition, diagnostic of systemic complement pathway activation. Although extremely uncommon following gynecologic surgery, aHUS should be considered in the setting of postoperative oliguric acute kidney injury, as prompt diagnosis is necessary to prevent significant morbidity and mortality.http://www.sciencedirect.com/science/article/pii/S2214911222000443MyomectomySurgical complicationsAtypical hemolytic uremic syndromeDisseminated intravascular coagulopathy, oliguria |
| spellingShingle | Kelsey Musselman Jeffrey Laurence Cynthia Magro Pasha Rahbari Thomas Di Vitantonio Yelena Havryliuk Atypical hemolytic uremic syndrome after myomectomy: A case report Case Reports in Women's Health Myomectomy Surgical complications Atypical hemolytic uremic syndrome Disseminated intravascular coagulopathy, oliguria |
| title | Atypical hemolytic uremic syndrome after myomectomy: A case report |
| title_full | Atypical hemolytic uremic syndrome after myomectomy: A case report |
| title_fullStr | Atypical hemolytic uremic syndrome after myomectomy: A case report |
| title_full_unstemmed | Atypical hemolytic uremic syndrome after myomectomy: A case report |
| title_short | Atypical hemolytic uremic syndrome after myomectomy: A case report |
| title_sort | atypical hemolytic uremic syndrome after myomectomy a case report |
| topic | Myomectomy Surgical complications Atypical hemolytic uremic syndrome Disseminated intravascular coagulopathy, oliguria |
| url | http://www.sciencedirect.com/science/article/pii/S2214911222000443 |
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