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Cystic Fibrosis and Hemolytic Uremic Syndrome Coexisting During Pregnancy

Department of Obstetrics and Gynecology, MCP-Hahnemann University Hospital, Philadelphia, Pennsylvania

Address reprint requests to: Lauren A. Plante, MD, MCP-Hahnemann University Hospital, Department of Obstetrics and Gynecology, Mail Stop 495, 245 N. 15th Street, Philadelphia, PA 19102; E-mail: lp33{at}drexel.edu.

ABSTRACT

BACKGROUND: As more women with cystic fibrosis are living into their reproductive years, this disease can complicate pregnancy and coexist with other entities. We report a case of cystic fibrosis with hemolytic uremic syndrome.

CASE: An 18-year-old primigravida with cystic fibrosis was admitted at term with pulmonary symptoms, hypertension, and thrombocytopenia. She was delivered with the admitting diagnosis of severe preeclampsia. Postpartum, thrombocytopenia, and microangiopathic hemolytic anemia worsened. She developed renal failure and acute respiratory distress syndrome, requiring plasmapheresis, mechanical ventilation, and hemodialysis. Renal biopsy was consistent with the diagnosis of hemolytic uremic syndrome.

CONCLUSION: Cystic fibrosis, a disease once managed predominantly by pediatric subspecialists, will be seen increasingly by physicians caring for adults, including obstetrician-gynecologists. We may also expect to see it coexisting with other disorders. The management of such patients may prove challenging.