Unusual Manifestation of Diarrhea-Associated Haemolytic Uraemic Syndrome in an Adult

Abstract

Hemolytic-Uremic Syndrome (HUS) is an uncommon disease characterized by microangiopathic hemolytica anaemia, thrombocytopenia, and acute renal failure. There are two forms of HUS: diarrhoea (D+)- and non-diarrhoea (D−)-associated HUS. We report the case of a 21-year-old woman presented to our department with jaundice, anaemia, thrombocytopenia, and anuria, preceded by a diarrheal prodrome, secondary to infection with Escherichia coli O157:H7. The whole clinical and laboratory investigation led to the diagnosis of HUS. Her condition was complicated with cholestasis, liver dysfunction, bleeding from the vagina, and myocardial involvement. She was treated only with fresh frozen plasma transfusions and hemodialysis, and despite the long duration of anuria (22 days), the patient showed subsequent improvement over days until full recovery one month later.

Keywords:

• Escherichia coli O157:H7
• hemolytic-uremic syndrome
• shiga toxin
• thrombotic thrombocytopenic purpura

Notes

This study was conducted independently. The authors did not receive financial or professional assistance with the preparation of the manuscript. Some of the authors have given talks, attended conferences, and participated in advisory boards and trials sponsored by various pharmaceutical companies.