Hemolytic uremic syndrome in pregnancy.

A 22-year-old primipara presented with hypertension, anemia, thrombocytopenia and elevated liver enzymes. She was initially managed as a case of HELLP syndrome but, with conventional treatment, the expected improvement did not occur. She later developed intractable oliguria and azotemia. The importance of considering hemolytic uremic syndrome, a distinct part of the spectrum of preeclampsia, separate from but overlapping with HELLP syndrome, was discussed. The need for vigilance in the management was emphasized since the definitive treatment and prognosis differ greatly between the two conditions.