Although she has no memory of it, she
somehow ended up in her bedroom,
where her husband found her a short
while later having a seizure. Terrified,
he called 911. She had a second seiz-
ure as she was rushed to the hospital.
Although doctors were able to stop
the seizures with medication, Megan’s
blood pressure skyrocketed. A CT scan
of her brain showed changes that can
be brought on by extreme hyperten-
sion. Meanwhile, Megan’s thoughts
were muddled—she could respond to
commands, but slowly—and her vision
was blurry and dark.
Megan was immediately transferred
to Penn State Health Milton S. Hershey
Medical Center, half an hour away and
better equipped for complex condi-
tions. Her husband and in-laws fretted
anxiously as doctors ran various tests
to figure out what was behind her high
blood pressure. Five days into the hos-
pital stay, Megan’s kidney function
started failing. “Nobody knew what
was happening,” she says.
“It was a pretty bad combination of
things,” says Dr. Umar Farooq, a
nephrologist on the team that treated
Megan. A kidney biopsy showed inflam-
mation and blood clots throughout the
tiny vessels in these organs. This type
of damage is known as hemolytic ure-
mic syndrome (HUS) and has several
possible causes, all of which require
different treatments.
Most of the time, HUS is caused by
an E. coli infection, but Megan didn’t
have any signs of this bacteria. Another
diagnosis that seemed likely to the
doctors on the team was lupus, as
Megan had tested positive for the anti-
bodies found with this autoimmune
condition. “I was almost hoping it was
lupus,” she says. This, at least, was
something she had heard of and knew
she’d be able to manage.
Five to 10 per cent of people without
lupus also carry these antibodies.
Nevertheless, Megan’s doctors started
her on a treatment, giving her steroids
and plasmapheresis, a procedure that
removes a patient’s blood plasma and
replaces it with healthy plasma.She didn’t improve, says Farooq:
“The kidneys, instead of getting better,
were getting worse—to the point where
we had to bring in dialysis.”
With Megan’s health declining,
Farooq was convinced they should
switch their attention to another con-
dition on their list of potential causes.
In very rare cases, patients have a
genetic predisposition to developing
HUS that emerges under stress. “In
Megan’s case, the stress on the bodyMEGAN’S DOCTOR
SUSPECTED HER
CONDITION WAS
BROUGHT ON BY
PREGNANCY STRESS.rd.ca 25