Evidence map›Paper›PMID 39722000›Full record

ArticleJournal of medical case reports2024

Cholecystectomy-induced thrombotic microangiopathy (TMA) in a postpartum patient successfully treated with eculizumab: a case report.

Ashley Meyer, Kathryn Uchida, Matthew Nguyen, Kenny Vongbunyong, Dong Ren, Ramy Hanna, Minh-Ha Tran, Omar Darwish

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of medical case reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

8 authors.

Ashley Meyer *Department of Internal Medicine, University of California Irvine Medical Center, 333 City Blvd West, Suite 500, Orange, CA, 92868, USA.
Kathryn Uchida *Department of Internal Medicine, University of California Irvine Medical Center, 333 City Blvd West, Suite 500, Orange, CA, 92868, USA.
Matthew NguyenDepartment of Internal Medicine, University of California Irvine Medical Center, 333 City Blvd West, Suite 500, Orange, CA, 92868, USA.
Kenny VongbunyongDepartment of Internal Medicine, University of California Irvine Medical Center, 333 City Blvd West, Suite 500, Orange, CA, 92868, USA.
Dong RenDepartment of Pathology and Laboratory Medicine, University of California, Irvine, Orange, CA, USA.
Ramy HannaDepartment of Internal Medicine, University of California Irvine Medical Center, 333 City Blvd West, Suite 500, Orange, CA, 92868, USA.
Minh-Ha TranDepartment of Pathology and Laboratory Medicine, University of California, Irvine, Orange, CA, USA.
Omar DarwishDepartment of Internal Medicine, University of California Irvine Medical Center, 333 City Blvd West, Suite 500, Orange, CA, 92868, USA. odarwish@uci.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThrombotic microangiopathy (TMA) is a rare, life-threatening disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ damage. Atypical hemolytic uremic syndrome (aHUS) is even less common, comprising less than 10% of hemolytic uremic syndrome (HUS) cases. aHUS in postpartum is associated with poor maternal outcomes, with the majority of cases resulting in end-stage renal disease. aHUS, unlike other types of TMA, is related to complement dysregulation. Thus, the current treatment of choice for aHUS is complement blockade, which limits unregulated activation of complement and complement-mediated end organ damage. CASE PRESENTATION: We present a rare case of a previously healthy, postpartum, 20-year-old Hispanic female patient who underwent a laparoscopic cholecystectomy and subsequently developed complement-mediated TMA, successfully treated with eculizumab. Unique to our case was renal failure owing to multiple insults and partial resolution of hematologic TMA findings prior to initiation of eculizumab.

conclusionOur case emphasizes the importance of clinicians possessing a high degree of clinical awareness and judgement surrounding complement-mediated TMA, aHUS and its subsets, and surgery as a precipitator, regardless of safety, particularly during the postpartum period.

Indexed as

Antibodies, Monoclonal, HumanizedPostpartum PeriodThrombotic MicroangiopathiesAtypical Hemolytic Uremic SyndromeCholecystectomy, LaparoscopicComplement Inactivating AgentsFemaleHumansTreatment OutcomeYoung AdultAntibodies, Monoclonal, HumanizedComplement Inactivating AgentseculizumabAtypical hemolytic uremic syndromeCase reportMicroangiopathic hemolytic anemiaThrombotic microangiopathy

Identifiers

PMID39722000
PMCPMC11670349

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