{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T19:40:02Z","timestamp":1721331602757},"reference-count":7,"publisher":"Federa\u00e7\u00e3o das Associa\u00e7\u00f5es de Ginecologia e Obstetr\u00edcia","issue":"04","license":[{"start":{"date-parts":[[2017,3,24]],"date-time":"2017-03-24T00:00:00Z","timestamp":1490313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ginecol Obstet"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A pregnancy complicated by typical hemolytic uremic syndrome (HUS) and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome is reported. At 20 weeks of gestation, a case of HUS was diagnosed, with Shiga toxin-producing Escherichia coli identified. Plasmapheresis allowed continuation of the pregnancy for 5 weeks. Superimposed preeclampsia and HELLP syndrome were diagnosed after the establishment of nephrotic range proteinuria, hypertension and recurrence of hemolysis. This is a singular case, as it demonstrates that HELLP syndrome can superimpose upon HUS, a fact that can impact future research on reproductive immunology. It also reminds clinicians that the overlapping of clinical and laboratory findings in HELLP syndrome makes the diagnosis of other thrombotic microangiopathies during pregnancy a clinical challenge.<\/jats:p>","DOI":"10.1055\/s-0037-1600124","type":"journal-article","created":{"date-parts":[[2017,3,25]],"date-time":"2017-03-25T04:58:08Z","timestamp":1490417888000},"page":"195-198","source":"Crossref","is-referenced-by-count":2,"title":["Hemolysis, Elevated Liver Enzymes, Low Platelets  Syndrome Superimposed on Hemolytic Uremic Syndrome"],"prefix":"10.61622","volume":"39","author":[{"given":"Madalena Gomes","family":"Concei\u00e7\u00e3o","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hospital CUF Descobertas, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo Pereira","family":"Gomes","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Hospital CUF Descobertas, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuno","family":"Clode","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Medicine, Centro Hospitalar Lisboa Norte, Hospital Santa Maria (CHLN-HSM), Lisbon, Portugal"},{"name":"Department of Medicine, Universidade de Lisboa, Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u00eas","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Medicine, Centro Hospitalar Lisboa Norte, Hospital Santa Maria (CHLN-HSM), Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"47794","published-online":{"date-parts":[[2017,3,24]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1053\/j.semperi.2009.02.004","article-title":"Imitators of severe pre-eclampsia","volume":"33","author":"B M Sibai","year":"2009","journal-title":"Semin Perinatol"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1111\/j.1365-2141.2008.07324.x","article-title":"Advances in understanding of pathogenesis of aHUS and HELLP","volume":"143","author":"C J Fang","year":"2008","journal-title":"Br J Haematol"},{"issue":"05","key":"ref3","first-page":"1122","article-title":"Hypertension in pregnancy. 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