2020 Volume 56 Issue 2 Pages 324-329
Thrombotic microangiopathy（TMA）is a syndrome characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ failure caused by small vessel thrombosis. TMAs are life threatening and pose medical emergencies as they worsen suddenly. This report presents the case of a 29-year-old woman, gravida 1, para 0, who was at 12 weeks’ gestation. She had been diagnosed with systemic lupus erythematosus（SLE）; however, the disease condition was stable when she became pregnant. She was diagnosed with TMA at 9 weeks’ gestation in the previous hospital after she presented with thrombocytopenia and renal failure. Plasma exchange did not show any effect; hence, she was transferred to our hospital. Based on the view that pregnancy caused TMA, we performed artificial abortion; however, her condition showed no improvement. As TMA develops secondary to SLE, we continued immunosuppressive therapy. However, she developed multiple complications, including bacteremia of Candida and multiple-drug-resistant Pseudomonas aeruginosa and hemophagocytic syndrome which led to her death. TMA is rare in pregnant or postpartum women; however, its occurrence increases among women with SLE. When we encounter TMA, early diagnosis and appropriate therapy could help us to prevent patients’ death.
