Postoperative hemolytic uremic syndrome with renal cortical necrosis following laparoscopic hemicolectomy.

Abstract:

:Non-Shiga-like toxin-producing Escherichia coli (STEC) or atypical hemolytic uremic syndrome (aHUS) is observed in 5-10% of all hemolytic uremic syndrome (HUS) cases, and usually develops secondary to infections, malignancies, drugs, transplantation, pregnancy, and autoimmune disease. However, there has been no report on adult onset HUS initiated by surgical procedures except transplantation. We report a 66-year-old woman who incurred renal impairment on the first day after laparoscopic hemicolectomy. Hemolytic anemia, thrombocytopenia, absence of Shiga toxin associated disease, normal ADAMTS13 activity, and low serum C3 (not C4) were consistent with a diagnosis of aHUS. We performed plasma exchange with fresh frozen plasma. Nevertheless, deteriorated renal function was not recovered after the treatment. Although it is an uncommon postoperative complication, aHUS needs to be considered as a possible cause of acute kidney injury combined with thrombocytopenia and anemia after surgical procedures, considering its different treatment modality and poor outcomes.

journal_name

Ren Fail

journal_title

Renal failure

authors

Lee JW,Won NH,Cho E,Kim MG,Jo SK,Cho WY,Kim HK

doi

10.3109/0886022X.2013.780978

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

725-8

issue

5

eissn

0886-022X

issn

1525-6049

journal_volume

35

pub_type

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