Atypical haemolytic uraemic syndrome (aHUS) is a form of thrombotic microangiopathy here precipitated by unopposed complement activation, the treatment of which has been revolutionised by the availability of the monoclonal anti-complement (C5) antibody, eculizumab.Historically, women with aHUS would be unable to achieve a successful pregnancy due to the severity of their renal disease and for the few who could conceive, recurrence of aHUS was a significant risk.In spite of this, parenthood remains a priority for many.
Experience with eculizumab use in the management of aHUS during pregnancy is growing and with it comes a significant change in the course of the disease.We present the case of a 28-year-old woman diagnosed with severe aHUS in the first trimester of her first pregnancy.She received rescue therapy with eculizumab princess polly dresses long sleeve and had a return to normal renal function.
While this pregnancy was lost, she strongly desired a family.We managed her through a subsequent pregnancy while receiving eculizumab.This pregnancy was uncomplicated and carried to term and she birthed a healthy 2500 g baby girl.
The complexities of managing a pregnancy in a woman with a history of aHUS are vast but not insurmountable, as demonstrated by this case.