A 22-year-old female was admitted with acute kidney failure following abruptio placentae causing severe vaginal haemorrhage in gestation week 33, resulting in stillbirth. The patient had a history of abortions in gestation weeks 9 and 28. Placental infarction at the second miscarriage resulted in heparin treatment during the actual pregnancy, which had been normotensive without proteinuria 2 days before admission. She presented with haemolytic anaemia, thrombocytopenia, schistocytes, uraemia, hypertension, oliguria and proteinuria. Treatment included plasmapheresis, haemodialysis and glucocorticoids. Anti-cardiolipin immunoglobulins, anti-Scl-70 and anti-double stranded DNA were negative. Anti-GBM and ANCA titers were not examined at disease onset, but were negative when examined 14 years later. Renal biopsy showed necrotic glomeruli with thrombi, platelet deposits and fibrin, vascular changes with luminal narrowing and intimal thickening, but no deposits. The diagnosis was TMA (pathologist Thomas Horn, MD, DMSc, Herlev Hospital, Denmark). A grand mal seizure occurred during hospitalization (no simultaneous metabolic derangements or severe hypertension). The clinical diagnosis was pregnancy-induced TMA with components of aHUS and TTP. After 6 months, kidney function improved and the patient was temporarily dialysis-independent for three years. She was never transplanted. A 69-year-old female was admitted with anuria and acute kidney failure. The patient had a 6-year hypertension history, hypothyroidism for 30 years and a minor stroke 4 months earlier treated by carotid thrombendarterectomy. At that time p-creatinine was normal. Blood tests showed severe uraemia and anaemia, but no haemolysis. The anti-GBM titer was positive, 95 U/mL (ELISA-kit, Wieslab, Sweden; ELISA-reader TECAN, Switzerland) and myeloperoxidase anti-neutrophil cytoplasmic antibodies titer (MPO ANCA) was 25 U/mL. Proteinase-3 ANCA was negative (ELISA-reader TECAN, Switzerland) and chest X-ray normal. Treatment included methylprednisolone, cyclophosphamide, plasmapheresis and haemodialysis. Renal biopsy showed diffuse extracapillary glomerulonephritis with predominantly fresh crescentic formations, focal and segmental necrosis and linear deposition of IgG along the glomerular basement membrane, consistent with anti-GBMGN (pathologist Claus B. Andersen MD, DMSc, Rigshospitalet, Denmark). The anti-GBM and MPO ANCA titres normalised after 16 days. There were no signs of TMA at any time. Kidney function was not regained.