POSTPARTUM HEMOLYTIC-UREMIC SYNDROME - A CASE WITH 2 EPISODES AFTER 2NORMAL PREGNANCIES AND DELIVERIES, WITH A GOOD PROGNOSIS

We report here a case with two episodes of postpartum HUS after two no rmal pregnancies and deliveries, and a good outcome, Repeated episodes of postpartum HUS have not been reported in the English-language lite rature and we believe this is the first case. A 28-year-old woman was admitted two days after a normal delivery because of severe hypertensi on, oliguric ARF, anemia associated with hemolysis and mild thrombocyt openia, Clinical examination, laboratory investigations, clinical cour se and findings from a percutaneous renal biopsy were consistent with the diagnosis of postpartum HUS. Treatment was instituted and she was discharged with complete recovery of renal function. The same situatio n was repeated three years later, 72 hours after the second normal del ivery. The diagnosis was the same, HUS. Alternative diagnoses were ver y carefully excluded in this case by appropriate investigations. Inter estingly, the ultrasonogram during both episodes was normal, but corti cal echogenicity was significantly higher than that of the liver. The treatment of the second episode was the same, with the addition of Vit . E. After three months, all parameters were normal. Possibly Vit. E i nfluenced the better outcome of the second episode. The finding of two episodes of postpartum HUS after two normal pregnancies and deliverie s, the good outcome, the hyperechogenicity on the ultrasonogram and th e better outcome of the second episode, during which the patient took Vit. E, incited us to report this case.