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Successful outcome of therapeutic plasma exchange in post-partum haemolytic-uraemic syndrome: a case report.

Adult, non-infective, post-partum haemolytic-uraemic syndrome (HUS) is a rare problem of pregnancy and puerperium but is an important differential diagnosis in the evaluation of thrombocytopenia. Like other causes of thrombocytopenia in pregnancy -pre-eclampsia and haemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome - this is a multisystem disorder associated with high morbidity and mortality in the absence of appropriate therapy. 
 
Patients with post-partum HUS display a classical triad of microangiopathic haemolytic anaemia, acute nephropathy, and thrombocytopenia. It is associated with a documented maternal mortality rate of 44% and perinatal mortality rate of 80%1. The treatment of post-partum HUS involves infusion of fresh-frozen plasma and steroids. Emergency therapeutic plasma exchange (TPE), carried out within 24 to 48 hours of diagnosis, may prevent the high mortality.