How are hemolytic uremic syndrome (HUS) or thrombotic thrombocytopenic purpura (TTP) managed in preeclampsia?

Updated: Nov 29, 2018
  • Author: Kee-Hak Lim, MD; Chief Editor: Ronald M Ramus, MD  more...
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Answer

Answer

Rarely, a patient may have elevated liver enzymes, thrombocytopenia, and renal insufficiency more than 72 hours after delivery. In these cases, the possibility of hemolytic uremic syndrome (HUS) or thrombotic thrombocytopenic purpura (TTP) must be considered. In such situations, plasmapheresis, along with corticosteroid therapy, may be of some benefit to such patients and must be discussed with renal and hematology consultants.

In addition, the use of dexamethasone (10 mg IV q6-12h for 2 doses followed by 5 mg IV q6-12h for 2 doses) has been proposed in the postpartum period to restore platelet count to normal range in patients with persistent thrombocytopenia. [73, 74] The effectiveness of this therapy in preventing severe hemorrhage or ameliorating the disease course needs further investigation.


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