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May 28, 1982

Treatment of Postpartum Hemolytic Uremic Syndrome With Plasma Exchange

Author Affiliations

From the Departments of Hematology (Dr Spencer), Obstetrics (Dr Crane), and Pathology (Dr Kumar), Walter Reed Army Medical Center, and the Department of Hematology (Dr Alving), Walter Reed Army Institute of Research, Washington. DC.

JAMA. 1982;247(20):2808-2809. doi:10.1001/jama.1982.03320450042030

POSTPARTUM hemolytic uremic syndrome (HUS) is a rare disease with a reported mortality of 61%.1 Heparin and antiplatelet agents are of unproved benefit in the treatment of HUS.2,3 Recently Remuzzi and co-workers4 demonstrated reversal of hemolysis and thrombocytopenia within 48 hours after a single plasma exchange in two middle-aged women with severe hypertension and HUS. The present report describes the treatment of HUS in a postpartum patient with plasma exchange alone, documenting the promptness with which it reversed hemolysis and thrombocytopenia in this setting.

Report of a Case  A 23-year-old woman (gravida 4, para 2, abortus 1) was seen at another hospital in her 34th gestational week with acute abdominal pain. She was preeclamptic. Her hematocrit reading was 20% and platelet count was 113,000/cu mm. She received packed RBCs and 2 units of fresh-frozen plasma. Five hours after admission she was spontaneously delivered of a stillborn infant