title: A case report of undiagnosed postpartum hemolytic uremic syndrome.
abstract: BACKGROUND
  Postpartum hemolytic uremic syndrome (PHUS) is a severe thrombotic microangiopathy (TMA) that is clinically characterized by hemolytic anemia, renal dysfunction, and low platelet levels after childbirth. Here, we report a rare case of unexpected death due to PHUS.
  
  
  METHODS
  A 23-year-old parturient had an uncomplicated cesarean section at 40 weeks gestation. The immediate postpartum course was uneventful. However, eight days post delivery, the patient developed severe nausea and vomiting followed by hematuria, spontaneous bruising, marked pallor, icteric sclera, and lethargy. Laboratory findings revealed that the patient had hemolytic anemia, thrombocytopenia, and acute renal failure. This patient died approximately 29 h after the onset of symptoms. Post-mortem examination confirmed that the patient had PHUS.
  
  
  CONCLUSIONS
  This paper addresses the need for a renal histological examination in addition to a thorough clinical history and appropriate laboratory tests for the rapid and accurate diagnosis of PHUS. Early detection and diagnosis can significantly improve the prognosis and optimize maternal outcomes.
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubei, 430030, PR China. 123730562@qq.com.|Department of Phatology, Hebei North University, No. 11 Zuanshinan Road, Zhangjiakou, Hebei, 075000, PR China. 123730562@qq.com.
authors.forename: Jiao
authors.initials: J
authors.lastname: Mu
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubei, 430030, PR China. 510602974@qq.com.
authors.forename: Ji
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Ministry of Health and Quality of Life, Victoria Hospital, Quatre Bornes, Mauritius. 378579104@qq.com.
authors.forename: Ananda
authors.initials: A
authors.lastname: Sunnassee
authors.affiliation: Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubei, 430030, PR China. hongmeidong1@hotmail.com.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Dong
mesh_terms: D017809:Fatal Outcome; D005260:Female; D006463:Hemolytic-Uremic Syndrome; D006801:Humans; D049590:Postpartum Period; D055815:Young Adult