{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T01:40:08Z","timestamp":1735177208894,"version":"3.32.0"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Thrombotic microangiopathy (TMA) is a rare, life-threatening disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ damage. Atypical hemolytic uremic syndrome (aHUS) is even less common, comprising less than 10% of hemolytic uremic syndrome (HUS) cases. aHUS in postpartum is associated with poor maternal outcomes, with the majority of cases resulting in end-stage renal disease. aHUS, unlike other types of TMA, is related to complement dysregulation. Thus, the current treatment of choice for aHUS is complement blockade, which limits unregulated activation of complement and complement-mediated end organ damage.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We present a rare case of a previously healthy, postpartum, 20-year-old Hispanic female patient who underwent a laparoscopic cholecystectomy and subsequently developed complement-mediated TMA, successfully treated with eculizumab. Unique to our case was renal failure owing to multiple insults and partial resolution of hematologic TMA findings prior to initiation of eculizumab.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our case emphasizes the importance of clinicians possessing a high degree of clinical awareness and judgement surrounding complement-mediated TMA, aHUS and its subsets, and surgery as a precipitator, regardless of safety, particularly during the postpartum period.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04804-9","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:01:50Z","timestamp":1735171310000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cholecystectomy-induced thrombotic microangiopathy (TMA) in a postpartum patient successfully treated with eculizumab: a case report"],"prefix":"10.1186","volume":"18","author":[{"given":"Ashley","family":"Meyer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenny","family":"Vongbunyong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramy","family":"Hanna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minh-Ha","family":"Tran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Darwish","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"issue":"1","key":"4804_CR1","doi-asserted-by":"publisher","first-page":"e125","DOI":"10.1055\/s-0036-1579539","volume":"6","author":"AF Saad","year":"2016","unstructured":"Saad AF, Roman J, Wyble A, Pacheco LD. Pregnancy-associated atypical hemolytic-uremic syndrome. AJP Rep. 2016;6(1):e125\u20138. https:\/\/doi.org\/10.1055\/s-0036-1579539.","journal-title":"AJP Rep"},{"issue":"2","key":"4804_CR2","doi-asserted-by":"publisher","first-page":"34","DOI":"10.5582\/irdr.2014.01001","volume":"3","author":"BS Kaplan","year":"2014","unstructured":"Kaplan BS, Ruebner RL, Spinale JM, Copelovitch L. Current treatment of atypical hemolytic uremic syndrome. Intractable Rare Dis Res. 2014;3(2):34\u201345. https:\/\/doi.org\/10.5582\/irdr.2014.01001.","journal-title":"Intractable Rare Dis Res"},{"issue":"3","key":"4804_CR3","doi-asserted-by":"publisher","first-page":"6625","DOI":"10.4081\/hr.2016.6625","volume":"8","author":"AG Raufi","year":"2016","unstructured":"Raufi AG, Scott S, Darwish O, et al. Atypical hemolytic uremic syndrome secondary to lupus nephritis, responsive to eculizumab. Hematol Rep. 2016;8(3):6625. https:\/\/doi.org\/10.4081\/hr.2016.6625.","journal-title":"Hematol Rep"},{"issue":"9","key":"4804_CR4","doi-asserted-by":"publisher","first-page":"2501","DOI":"10.3390\/jcm11092501","volume":"11","author":"TTW van Herpt","year":"2022","unstructured":"van Herpt TTW, Timmermans SAMEG, van Mook WNKA, et al. Postsurgical thrombotic microangiopathy and deregulated complement. J Clin Med. 2022;11(9):2501. https:\/\/doi.org\/10.3390\/jcm11092501.","journal-title":"J Clin Med"},{"issue":"16","key":"4804_CR5","doi-asserted-by":"publisher","first-page":"2090","DOI":"10.1182\/bloodadvances.2018019596","volume":"2","author":"MH Park","year":"2018","unstructured":"Park MH, Caselman N, Ulmer S, Weitz IC. Complement-mediated thrombotic microangiopathy associated with lupus nephritis. Blood Adv. 2018;2(16):2090\u20134. https:\/\/doi.org\/10.1182\/bloodadvances.2018019596.","journal-title":"Blood Adv"},{"issue":"19","key":"4804_CR6","doi-asserted-by":"publisher","first-page":"2103","DOI":"10.1182\/blood.2020005221","volume":"136","author":"F Fakhouri","year":"2020","unstructured":"Fakhouri F, Scully M, Prov\u00f4t F, et al. Management of thrombotic microangiopathy in pregnancy and postpartum: report from an international working group. Blood. 2020;136(19):2103\u201317. https:\/\/doi.org\/10.1182\/blood.2020005221.","journal-title":"Blood"},{"key":"4804_CR7","doi-asserted-by":"publisher","first-page":"69","DOI":"10.2147\/POR.S169255","volume":"9","author":"J Blythe","year":"2018","unstructured":"Blythe J, Herrmann E, Faust D, et al. Acute cholecystitis\u2014a cohort study in a real-world clinical setting (REWO study, NCT02796443). Pragmat Obs Res. 2018;9:69\u201375. https:\/\/doi.org\/10.2147\/POR.S169255.","journal-title":"Pragmat Obs Res"},{"key":"4804_CR8","unstructured":"Hassler KR, Collins JT, Philip K, Jones MW. Laparoscopic cholecystectomy. In: StatPearls. StatPearls Publishing; 2023. Accessed 17 Nov 2023. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK448145\/."},{"issue":"2","key":"4804_CR9","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1159\/000492033","volume":"48","author":"SR Olson","year":"2018","unstructured":"Olson SR, Lu E, Sulpizio E, Shatzel JJ, Rueda JF, DeLoughery TG. When to stop eculizumab in complement-mediated thrombotic microangiopathies. Am J Nephrol. 2018;48(2):96\u2013107. https:\/\/doi.org\/10.1159\/000492033.","journal-title":"Am J Nephrol"},{"issue":"11","key":"4804_CR10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0206558","volume":"13","author":"MG Uriol Rivera","year":"2018","unstructured":"Uriol Rivera MG, Cabello Pelegrin S, Ballester Ruiz C, et al. Impact of a multidisciplinary team for the management of thrombotic microangiopathy. PLoS ONE. 2018;13(11): e0206558. https:\/\/doi.org\/10.1371\/journal.pone.0206558.","journal-title":"PLoS ONE"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04804-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-024-04804-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04804-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T01:02:02Z","timestamp":1735174922000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-024-04804-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,26]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4804"],"URL":"https:\/\/doi.org\/10.1186\/s13256-024-04804-9","relation":{},"ISSN":["1752-1947"],"issn-type":[{"type":"electronic","value":"1752-1947"}],"subject":[],"published":{"date-parts":[[2024,12,26]]},"assertion":[{"value":"16 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 September 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 December 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"610"}}