Journal of Clinical Medicine
Postpartum Triple Allograft Injury with Atypical Hemolytic Uremic Syndrome, Recurrent IgA Nephropathy, and Antibody-Mediated Rejection in a Kidney Retransplant Recipient: A Case Report
By Xuelian Chen, Dong Wang, Lichuan Yang and 2 others.
Abstract
Background
The concurrent presentation of chronic hypertension with superimposed preeclampsia, postpartum atypical hemolytic uremic syndrome (aHUS), recurrent IgA nephropathy (IgAN), and antibody-mediated rejection (ABMR) constitutes a life-threatening clinical emergency. To the best of our knowledge, the coexistence of all these complications has rarely been documented in the literature, representing an extremely rare clinical phenotype.
Methods
This study presents a 33-year-old female who had undergone two prior living-donor kidney transplantations. She underwent emergency cesarean section at 32 weeks of gestation due to threatened uterine rupture superimposed with preeclampsia. Postoperatively, allograft function deteriorated rapidly. Renal allograft biopsy confirmed triple pathological lesions including recurrent IgAN, aHUS, and ABMR. Genetic testing detected no pathogenic mutations classically associated with aHUS.