scholarly journals Hemolytic uremic syndrome caused by Shiga toxin-producing Escherichia coli in a renal transplant recipient case report

2020 ◽  
Author(s):  
John Fredy Nieto-Rios ◽  
Monica Zuluaga-Quintero ◽  
Julio Cesar Valencia-Maturana ◽  
Diana Carolina Bello-Marquez ◽  
Arbey Aristizabal-Alzate ◽  
...  
Keyword(s):  
Transplant Recipient ◽  
Hemolytic Uremic Syndrome ◽  
Shiga Toxin ◽  
Kidney Transplant Recipient ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Fatal Outcome ◽  
Rare Condition ◽  
High Morbidity ◽  
Solid Organ ◽  
Uremic Syndrome

Abstract Thrombotic microangiopathies are disorders characterized by nonimmune microangiopathic hemolytic anemia, thrombocytopenia, and multi-systemic failure. They are classified as thrombotic thrombocytopenic purpura, atypical hemolytic-uremic syndrome, and typical hemolytic uremic syndrome. The latter is associated with intestinal infections by Shiga toxin-producing bacteria. Typical hemolytic uremic syndrome in adults is an extremely rare condition, characterized by high morbidity and mortality. It has been seldom described in solid organ transplant recipients. Here is presented the case of a kidney transplant recipient who had typical hemolytic uremic syndrome with multisystem commitment, refractory to management and with a fatal outcome.

Atypical hemolytic uremic syndrome: from diagnosis to treatment

2015 ◽  
Vol 53 (11) ◽  
Author(s):  
Massimo Franchini
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Shiga Toxin ◽  
Thrombotic Microangiopathy ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Rare Condition ◽  
Organ Damage ◽  
Thrombocytopenic Purpura ◽  
Haemolytic Uremic Syndrome ◽  
Uremic Syndrome

AbstractThrombotic microangiopathy (TMA) is a relatively rare condition but a medical urgency requiring immediate intervention to avoid irreversible organ damage or death. Symptoms on presentation include microangiopathic haemolytic anaemia, thrombocytopenia and organ damage. The most frequent direct causes of TMA are thrombotic thrombocytopenic purpura (TTP) and haemolytic uremic syndrome (HUS). The most common form of HUS is related to Shiga toxin producing

scholarly journals Neonatal Atypical Hemolytic Uremic Syndrome in the Eculizumab Era

2021 ◽  
Vol 11 (02) ◽  
pp. e95-e98
Author(s):  
Sara Madureira Gomes ◽  
Rita Pissarra Teixeira ◽  
Gustavo Rocha ◽  
Paulo Soares ◽  
Hercilia Guimaraes ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Hemolytic Uremic Syndrome ◽  
Perinatal Asphyxia ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Congenital Infection ◽  
High Morbidity ◽  
Severe Renal Failure ◽  
Emergency Cesarean ◽  
Uremic Syndrome

AbstractThe atypical hemolytic uremic syndrome (aHUS) in the newborn is a rare disease, with high morbidity. Eculizumab, considered a first-line drug in older children, is not approved in neonates and in children weighing less than 5 kg. We present a 5-day-old female newborn, born at 36 weeks' twin gestation, by emergency cesarean section due to cord prolapse, with birth weight of 2,035 g and Apgar score of 7/7/7, who develops microangiopathic hemolytic anemia, thrombocytopenia, and progressive acute renal failure. In day 5, after diagnosis of aHUS, a daily infusion of fresh frozen plasma begins, with improvement of thrombocytopenia and very slight improvement in renal function. The etiologic study (congenital infection, Shiga toxin, ADAMTS13 activity, directed metabolic study) was normal. C3c was slightly decreased. On day 16 for maintenance of anemia and severe renal failure, she started 300 mg/dose eculizumab. Anemia resolves in 10 weeks and creatinine has normal values after 13 weeks of treatment. The genetic study was normal. In this case, eculizumab is effective in controlling microangiopathy and in the recovery of renal function. Diagnosis of neonatal aHUS can be challenging because of phenotypic heterogeneity and potential overlap with other manifestations that may confound it, such as perinatal asphyxia or sepsis/disseminated intravascular coagulation.

scholarly journals Desafios Diagnósticos e Terapêuticos na Síndrome Hemolítica Urémica Atípica: A Propósito de Um Caso Clínico

2019 ◽  
Vol 32 (10) ◽  
pp. 673
Author(s):  
Sofia Reis ◽  
Daniela Ramos ◽  
Carolina Cordinhã ◽  
Clara Gomes
Keyword(s):  
Differential Diagnosis ◽  
Hemolytic Uremic Syndrome ◽  
Shiga Toxin ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Specific Treatment ◽  
Neurological Involvement ◽  
Thrombocytopenic Purpura ◽  
Alternate Pathway ◽  
Uremic Syndrome ◽  
Deficient Activity

The atypical hemolytic uremic syndrome comprises a thrombotic microangiopathy resulting from the complement alternate pathway hyperactivation. Its severity requires early diagnosis and treatment. The differential diagnosis includes typical hemolytic uremic syndrome (associated with Shiga toxin) and thrombotic thrombocytopenic purpura (associated with deficient activity of ADAMTS13). The only specific treatment currently available for atypical hemolytic uremic syndrome is eculizumab. We describe the case of a child with atypical hemolytic uremic syndrome diagnosed in the context of bloody diarrhea, complicated by neurological involvement that posed several diagnostic and therapeutic challenges.

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