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Cyclosporine‐associated post‐partum haemolytic uraemic syndrome in a renal transplant patient: lack of response to plasmapheresis but remission after intravenous immunoglobulin G
Author(s) -
Bastani Bahar,
Mistry Bhargav M,
Jamal Jawaid A,
Contis Joseph
Publication year - 2001
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1046/j.1440-1797.2001.00041.x
Subject(s) - medicine , plasmapheresis , prednisone , pregnancy , surgery , immunosuppression , antibody , immunology , biology , genetics
SUMMARY: We present the case of a young woman who developed severe post‐partum (cyclosporine‐associated) haemolytic uraemic syndrome (HUS) 6 years after a living related donor kidney transplant. Her pregnancy had become complicated with preeclampsia (hypertension and nephrotic syndrome) and progressive renal insufficiency extending for 1 month after delivery, and there was evidence of cyclosporine vasculopathy on a kidney biopsy. Despite six daily treatments with plasmapheresis and fresh‐frozen plasma replacement, her HUS progressively deteriorated, culminating in severe pulmonary haemorrhage. At this point, treatment with i.v. infusion of immunoglobulin G was initiated, which resulted in resolution of HUS. Moreover, at the time of diagnosis of HUS the patient was taken off cyclosporine and maintained on mycophenolate mofetil and prednisone.