Abstract:A síndrome hemolítico-urêmica (SHU) é processo microangiopático associado a insuficiência renal, determinando alta morbidade e mortalidade. A gestação pode ser um fator precipitante, por meio de mecanismos ainda não bem estabelecidos. Entram no diagnóstico diferencial a pré-eclâmpsia, a síndrome HELLP, o fígado gorduroso agudo da gestação e a púrpura trombocitopênica trombótica. Relatamos um caso de SHU ocorrendo no pós-parto imediato em paciente com diagnóstico inicial de pré-eclâmpsia. O diagnóstico diferenc… Show more
“…(6)(7)(8) There is no correlation between severity scores (enhancing neurological symptoms, renal function and hematological changes) and in the long term prognosis involving TTP and HUS in pregnant women, although permitting a later occurrence of new events. (9)(10)(11) International associations of blood banks and apheresis and the British Committee for Standards in Hematology have established treatment of TTP based upon daily plasmapheresis stipulated by exchange of 1 to 1.5 times the volemia, until platelet count exceeds 150.000/mm 3 , and LDH at normal levels with a low rate of reported complications,. Associated use of steroids in moderate to high doses in idiopathic or refractory cases is recommended, as well as use of immunosuppressive agents, (3) or even administration of ADAMTS-13 by plasmapheresis.…”
“…(6)(7)(8) There is no correlation between severity scores (enhancing neurological symptoms, renal function and hematological changes) and in the long term prognosis involving TTP and HUS in pregnant women, although permitting a later occurrence of new events. (9)(10)(11) International associations of blood banks and apheresis and the British Committee for Standards in Hematology have established treatment of TTP based upon daily plasmapheresis stipulated by exchange of 1 to 1.5 times the volemia, until platelet count exceeds 150.000/mm 3 , and LDH at normal levels with a low rate of reported complications,. Associated use of steroids in moderate to high doses in idiopathic or refractory cases is recommended, as well as use of immunosuppressive agents, (3) or even administration of ADAMTS-13 by plasmapheresis.…”
“…12 O uso de plasma humano tem sido freqüentemente usado por vários motivos: 1. reposição de fator estimulador de prostaglandinas, 2. inibição de fatores de agregação plaquetária, 3. neutralização de alguns fatores possivelmente tóxi-cos para o endotélio que acreditam estar envolvido na fisiopatologia da doença. 7 Plasmaférese não apresentou vantagens específicas, excetos em casos de oligúria o qual seria a única opção para a infusão de plasma humano, porém o seu uso é frequentemente defendido, apresentando bons resultados quando outras medidas terapêuticas falham.…”
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