Volume 26, Issue 122, April 2022

Post covid pregnancy related haemolytic Uraemic syndrome masquerading as HELLP syndrome-A twisted tale of gravid

Tanvi Chaurasia¹, Deepti Shrivastava^1♦, Kamlesh Chaudhary², Rahul Agola³, Geeta Chaurasia⁴

¹Post Graduate Resident, Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
²Professor, Department of Obstetrics and Gynaecology, Jawaharlal Nehru medical college, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
³Post Graduate Resident, Department of Orthopaedics, Jawaharlal Nehru medical college, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
⁴Senior consultant, Department of Obstetrics and Gynaecology, District hospital Chhatarpur (Madhya Pradesh), India

^♦Corresponding author
Professor, Department of Obstetrics and Gynaecology, Jawaharlal Nehru medical college, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India

ABSTRACT

Pregnancy associated atypical haemolytic uremic syndrome (p-aHUS) is an infrequent condition to be encountered during the puerperium period and is associated with microangiopathic haemolytic anaemia, thrombocytopenia as well as acute kidney injury. This syndrome is triggered by pregnancy in the women who are predisposed genetically leading to an unfortunate haemolytic disease which is associated with endothelial diffuse damage and consumption of the platelets. This is a dangerous condition which required prompt diagnosis as well as management. Diagnosing p-a HUS can be challenging for the treating clinicians as it may mimic other conditions like HELLP Syndrome during the pregnancy as well as postpartum period. Plasma exchange should be started within 24 hours of diagnosing the condition in order to prevent mortality. With the emergence of the corona virus pandemic, atypical SARS Covid -2 presentations during pregnancy have emerged, ranging from COVID-19-associated HELLP syndrome to intrauterine death. COVID-19 has been linked to an atypical haemolytic uremic syndrome, with COVID-19 causing ischemic acute tubular necrosis or thrombotic microangiopathy through a complex complement activation process. We are presenting a case of 28 year old female with nine months amenorrhea who presented with bilateral pedal oedema and oliguria since one week and had severe thrombocytopenia along with acute kidney injury following 28 days of contracting COVID-19. She was diagnosed as Post COVID-19 p-a HUS following diagnostic work up and was treated promptly with plasmapheresis leading to complete recovery.

Keywords: pregnancy, Haemolytic Uremic Syndrome, plasmapheresis, HELLP syndrome

Medical Science, 2022, 26, ms139e2128

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DOI: https://doi.org/10.54905/disssi/v26i122/ms139e2128

Published: 18 April 2022