Postpartum hemolytic uremic syndrome in Tibet Autonomous Region, China: a retrospective analysis of 11 cases

Abstract

Objective To investigate the clinical features of postpartum hemolytic uremic syndrome (PHUS) in Tibetan women, and to improve the diagnosis and treatment of PHUS. Methods From January 2013 to June 2018, 11 patients diagnosed with PHUS in the Tibet Autonomous Regional People's Hospital were enrolled. Clinical manifestations, laboratory testing results, treatments and outcomes were retrospectively analyzed. A descriptive statistical analysis was applied in this study. Results The average age of the 11 patients was (27.0±6.2) years old, and all were Tibetans. Five of them delivered by cesarean section and eight complicated by hypertension. The onset of PHUS was 1-3 d after delivery. The mean hemoglobin concentration [(73.5±26.3) g/L] and platelet count [(51±31)×109/L] remarkably decreased. Patients' renal functions were also significantly impaired with an average serum creatinine level of (517±184) μmol/L. Nine women required hemodialysis, seven received plasma infusion and six underwent glucocorticoid therapy. No patients received plasma exchange or eculizumab therapy due to limited resources. Seven out of the nine patients who underwent hemodialysis could withdraw from dialysis. Conclusions PHUS is relatively rare, and characterized by acute onset after birth and severe conditions, especially renal injury. However, most patients would have better prognosis after active treatment. Key words: Hemolytic-uremic syndrome; Puerperal disorders