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Figure 1 | Journal of Medical Case Reports

Figure 1

From: Postpartum thrombotic microangiopathy revealed as atypical hemolytic uremic syndrome successfully treated with eculizumab: a case report

Figure 1

Response to eculizumab treatment in a young woman of Hellenic origin who was diagnosed with atypical hemolytic uremic syndrome following a preeclampsia-induced premature delivery. At admission, laboratory results indicated thrombotic microangiopathy, acute kidney failure and thrombocytopenia; creatinine level 4.9mg/dL; lactate dehydrogenase 3254IU/L; platelets 40×109/L, with the presence of schistocytes. Plasmapheresis and dialysis managed to temporarily correct clinical indices, however, following deterioration of her clinical status, our patient was started on eculizumab, 900mg per week, in July 2011. Her clinical condition started to improve after the first administration of eculizumab. However, due to drug accessibility, the complete dosing schedule of eculizumab could not be maintained and our patient presented with pneumonia and cardiac failure and was admitted to the intensive care unit. Due to the persistence of her clinical condition (thrombocytopenia; platelets 73×109/L, renal failure; creatinine 4.85mg/dL, microangiopathy; lactate dehydrogenase 1024IU/L), eculizumab was reinstated starting at 900mg followed by 1200mg fortnightly. Clinical and laboratory symptoms of thrombotic microangiopathy started to decline and our patient achieved normal renal function after administration of the first doses of eculizumab. Our patient remains on 1200mg eculizumab administered every two weeks and is free of any symptoms of thrombotic microangiopathy.

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