产后肾衰竭：一例复杂病例，可能并存溶血、肝酶升高、血小板计数降低及溶血尿毒综合征。
Postpartum renal failure: a complex case with probable coexistence of hemolysis, elevated liver enzymes, low platelet count, and hemolytic uremic syndrome.
作者信息
Kahra K, Draganov B, Sund S, Hovig T
机构信息
Department of Obstetrics and Gynecology, Ringerike Hospital, Hønefoss, Norway.
出版信息
Obstet Gynecol. 1998 Oct;92(4 Pt 2):698-700. doi: 10.1016/s0029-7844(98)00196-3.
BACKGROUND
Postpartum renal failure in previously healthy subjects is associated most often with preeclampsia and/or hypertension; hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, hemolytic uremic syndrome; or thrombotic thrombocytopenic purpura. Transient oliguria associated with preeclampsia is common, but renal failure is rare. Coexistence of HELLP and hemolytic uremic syndromes has been suggested, but histopathologic documentation of this combination has been scarce.
CASE
A 30-year-old primigravida with severe preeclampsia at 35 weeks and 3 days' gestation presented with the development of HELLP syndrome and renal failure postpartum. Histopathologic lesions characteristic of hemolytic uremic syndrome were present in the kidney.
CONCLUSION
Probable overlapping of HELLP and hemolytic uremic syndromes in pregnancy or postpartum should be taken into consideration when treating patients with these syndromes and associated complications, such as renal failure.
背景
既往健康的受试者产后肾衰竭最常与子痫前期和/或高血压、溶血、肝酶升高、血小板减少（HELLP）综合征、溶血尿毒综合征或血栓性血小板减少性紫癜相关。子痫前期相关的短暂少尿很常见，但肾衰竭罕见。有人提出HELLP和溶血尿毒综合征并存，但这种组合的组织病理学记录很少。
病例
一名30岁初产妇，孕35周零3天时患重度子痫前期，产后出现HELLP综合征和肾衰竭。肾脏存在溶血尿毒综合征的特征性组织病理学病变。
结论
在治疗患有这些综合征及相关并发症（如肾衰竭）的患者时，应考虑到妊娠或产后HELLP和溶血尿毒综合征可能存在重叠。
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