Microangiopathic hemolytic anemia in pregnancy

Mohammed Salhab1, Andrew Hsu2, Elizabeth Ryer2

  • 1University of Massachusetts Medical School, Department of Medicine, United States; University of Massachusetts Medical School, Department of Hematology and Oncology, United States.

Microangipathic hemolytic anemia (MAHA) is a serious diagnosis and difficult to manage in pregnant patients as multiple life threatening conditions could present with MAHA. ADAMTS13 enzyme activity can be affected during pregnancy with multiple factors. A persistent extremely low ADAMTS13 enzyme activity levels, without an inhibitor, after the delivery was an important factor to establish the diagnosis. We present a case of likely congenital ADAMST13 deficiency that manifested for the first time in a pregnant woman at week 37 of pregnancy.