Pregnancy-related thrombotic microangiopathies: Clues from complement biology

Details

Serval ID
serval:BIB_106FC70055D7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Pregnancy-related thrombotic microangiopathies: Clues from complement biology
Journal
Transfus Apher Sci
Author(s)
Fakhouri F.
ISSN
1473-0502 (Print)
ISSN-L
1473-0502
Publication state
Published
Issued date
04/2016
Volume
54
Number
2
Pages
199-202
Language
english
Notes
Fakhouri, Fadi
eng
Review
England
Transfus Apher Sci. 2016 Apr;54(2):199-202. doi: 10.1016/j.transci.2016.04.009. Epub 2016 Apr 25.
Abstract
Pregnancy is a high-risk period for various types of thrombotic microangiopathies (TMA). The improvement of our understanding of the pathophysiology of TMAs has translated into better management of pregnancy-related TMAs. The two main types of TMA, TTP (thrombotic thrombocytopenic purpura) and hemolytic uremic syndrome (HUS), can both occur during pregnancy and postpartum. TTP is related in most cases to acquired or congenital deficiency of ADAMTS13; it tends to develop mainly during the second and third trimesters of pregnancy. The treatment of pregnancy-TTP aims to restore a detectable ADAMTS13 activity through plasma therapy, and if needed, to induce or sustain remission, immunosuppressive agents. In contrast, HUS develops mainly in the postpartum period. Accumulating data indicate that pregnancy-HUS is an atypical, i.e., complement-mediated HUS, triggered by pregnancy. Its treatment therefore should include the use of the anti-C5 humanized monoclonal antibody eculizumab. In other TMA-like disorders associated with pregnancy, including HELLP (hemolysis, elevated liver enzymes, low platelets) and pre-eclampsia/eclampsia, complement involvement, and the need for specific anti-complement therapies, is an active area of investigation.
Keywords
Emtricitabine, Rilpivirine, Tenofovir Drug Combination/*blood, Female, *Hemolytic-Uremic Syndrome/blood/diagnosis/pathology, Humans, Pregnancy, *Pregnancy Complications, Hematologic/blood/diagnosis/therapy, *Purpura, Thrombotic Thrombocytopenic/blood/diagnosis, *Thrombotic Microangiopathies/blood/diagnosis/therapy, Complement, Hellp, Hemolytic uremic syndrome, Thrombotic microangiopathy
Pubmed
Create date
01/03/2022 11:18
Last modification date
02/03/2022 7:35
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