Successful Subsequent Pregnancy in a Woman Receiving Eculizumab for Pregnancy-Associated Atypical Haemolytic Uraemic Syndrome

Abstract EN

Atypical haemolytic uraemic syndrome (aHUS) is a form of thrombotic microangiopathy precipitated by unopposed complement activation, the treatment of which has been revolutionised by the availability of the monoclonal anti-complement (C5) antibody, eculizumab.

Historically, women with aHUS would be unable to achieve a successful pregnancy due to the severity of their renal disease and for the few who could conceive, recurrence of aHUS was a significant risk.

In spite of this, parenthood remains a priority for many.

Experience with eculizumab use in the management of aHUS during pregnancy is growing and with it comes a significant change in the course of the disease.

We present the case of a 28-year-old woman diagnosed with severe aHUS in the first trimester of her first pregnancy.

She received rescue therapy with eculizumab and had a return to normal renal function.

While this pregnancy was lost, she strongly desired a family.

We managed her through a subsequent pregnancy while receiving eculizumab.

This pregnancy was uncomplicated and carried to term and she birthed a healthy 2500 g baby girl.

The complexities of managing a pregnancy in a woman with a history of aHUS are vast but not insurmountable, as demonstrated by this case.