Hypertension and Pregnancy: AHD Exemplary Treatment Approach - Patient case study

Case history: How did the journey begin? 

NA, a 27-year-old female, presented at American Hospital Dubai with a headache and high blood pressure a week after her delivery. She was found to have sudden and new kidney failure with a significant drop in her platelet count.  

There were critical factors that required urgent and accurate diagnosis. Post-partum complications involving hypertension, platelet count drop, and new kidney failure can be caused by various issues. What was causing NA's condition so soon after delivery? 

It was imperative to diagnose her state quickly and accurately. 

Initial Assessment and Accurate Diagnosis 

NA was admitted to American Hospital Dubai, and our Nephrology team swung into action along with other specialists. After conducting several tests, our nephrologists ruled out other causes for JA's blood pressure, platelets count drop, and new kidney failure to arrive at the suspicion of a rare and devastating disorder called atypical Hemolytic Uremic Syndrome (aHUS). aHUS can be triggered by pregnancy, and they concluded it was the most likely case. 

It is important to note that aHUS is different from HUS (Hemolytic Uremic Syndrome), caused by E. coli-producing toxins that are usually food-borne. 

aHUS causes tiny blood clots to form in the body's small blood vessels, blocking blood flow to essential organs, including the kidneys, leading to sudden kidney failure. It leads to a group of disorders called thrombotic microangiopathies characterized by microangiopathic hemolytic anemia (red blood cell destruction in the micro blood vessels), thrombocytopenia (deficiency of platelets in the blood) and uremia (inability of the kidneys to process waste products from the blood to be carried out by urine).  

These life-threatening conditions explain NA's sudden drop in platelet count and new kidney failure requiring urgent management. 

How We Achieved the Breakthrough 

The significant challenge to diagnosing aHUS is its symptoms overlap with many similar disease processes, thus posing a challenge to clinicians and potentially delaying the start of treatment. 

It is critical to arrive at the correct diagnosis quickly.

The patient and family were deeply anxious about the potential complications as the patient was completely healthy before the present condition. However, the American Hospital Dubai team of specialists and experts showed exemplary expertise and early recognition of this disorder to ensure NA's treatment pathway was cleared for success straightaway. The diagnosis was a breakthrough. 

Initiating the Proper Treatment Approach 

NA's treatment was initiated with Eculizumab. It is well-established that after the aHUS diagnosis, early administration of Eculizumab ensures highly favorable outcomes, and NA showed a dramatic improvement in blood pressure and kidney function after her treatment plan was begun. Due to the severity of the disorder, she was close to starting dialysis to keep her kidney functions going; however, thanks to our nephrologists' timely diagnosis and treatment with the correct medication, we prevented her from reaching the dialysis stage.  

Achieving a Positive Care Outcome 

This case highlights the urgency and expertise required to diagnose and treat a devastating systemic disease triggered by a normal physiological phenomenon. NA was healthy before and during pregnancy, so it was devastating for her and her family to undergo this experience of developing severe hypertension and kidney failure right after the joyous moment of delivery.  

The dramatic improvement in her condition was a life-changing experience for NA. She is doing well, and we will closely follow her condition to lower the risk of blood pressure or kidney issues in future pregnancies because she is at increased risk. 

American Hospital Dubai's timely and accurate diagnosis, based on its exemplary expertise and experience in complex conditions, helped NA get the highest level of care and ensure her speedy journey back to health. 

Conclusion 

aHUS is a complex disorder that calls for accurate diagnosis and treatment at the earliest. If misdiagnosed or delayed for treatment, it can lead to irreversible kidney failure, so precise and rapid intervention through the correct treatment is crucial for optimal management. Arriving at the diagnosis requires experience, skill and expertise, and American Hospital Dubai has once again set a precedent for providing highly effective and exemplary care for complex conditions.