Summary of - Role of Therapeutic Plasma Exchange in managing complement mediated thrombotic microangiopathy – Case series

Document Type

Article

Abstract

thrombi causing end organ damage

We are presenting a case series of complement mediated TMA where Therapeutic Plasma Exchange (TPE) had been used as an adjuvant therapy (Category III, Grade 2C[3,4] as per ASFA 2019 guidelines). We did a retrospective analysis of TPE procedures performed, over a period of 2 years (2019 and 2020) during which 5 cases of complement mediated, pregnancy associated TMA. The diagnosis of TMA in pregnancy can be challenging because of the overlapping manifestations of severe preeclampsia, HELLP syndrome, acute fatty liver of pregnancy, APLA and Sepsis. In the present case series, development of end organ damage (AKI) during post-partum period in all the patients favored a diagnosis of complement mediated TMA . Patients with preeclampsia or HELLP syndrome during pregnancy have a predilection to develop TMA in the postpartum period. Timely and an accurate diagnosis of TMA in the postpartum period is crucial since the management of TMA varies significantly from other conditions and failure to diagnose complement mediated TMA can lead to severe consequences. Timely TPE might help in inhibiting or limiting the microangiopathic changes leading to a better prognosis, however it may not be considered as an alternative to renal replacement therapy.

Publication Date

2022

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