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August 21, 1967

Malignant Nephrosclerosis in Women Post PartumA Note on Microangiopathic Hemolytic Anemia

Author Affiliations

From the departments of medicine (Dr. Scheer) and pathology (Dr. Jones), State University of New York Medical Center, Syracuse.

JAMA. 1967;201(8):600-604. doi:10.1001/jama.1967.03130080042009

A case of malignant nephrosclerosis with microangiopathic hemolytic anemia developed in a young woman post partum. Diastolic hypertension first appeared two weeks after admission but papilledema never developed. An explanation for this phenomenon may be that the partially occluded renal arterioles caused activation of the renin-angiotensin system. Similar cases in other institutions suggest that such a syndrome occurs occasionally in women in the postpartum period. Microangiopathic hemolytic anemia, as well as malignant hypertension and nephrosclerosis, has been produced by treating rats with salt and desoxycorticosterone. Red blood cell fragmentation may occur by the shearing action of blood flow on erythrocytes observed to be adherent to arteriolar and glomerular capillary walls.