American Journal of Nephrology
Case Report
A 12-Year-Old Girl with Hemolytic Uremic Syndrome as Initial Symptom of Systemic Lupus erythematosus and a Literature ReviewKawasaki Y. · Suzuki J. · Nozawa R. · Suzuki S. · Suzuki H.Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
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Article / Publication Details
Received: October 02, 2001
Accepted: June 11, 2002
Published online: October 07, 2002
Issue release date: September – December
Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 3
ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)
For additional information: https://www.karger.com/AJN
Abstract
We describe a 12-year-old girl with systemic lupus erythematosus (SLE) who first presented with an atypical hemolytic uremic syndrome (HUS) associated with hypocomplementemia, and compare the clinical manifestations and prognosis between SLE patients with HUS and thrombotic thrombocytopenic purpura in the reported literature. Diagnoses were based on renal failure, hemolytic anemia, and thrombocytonemia, including the observation of fragmented red blood cells, hypocomplementemia and on the American College of Rheumatology criteria for SLE. Cocktail therapy may have been effective against the pathological condition of SLE. In 4 patients with SLE and HUS, prednisolone and immunosuppressive drugs were administered, and none of the patients suffered from chronic renal insufficiency. The prognosis for SLE patients with HUS is good. These findings suggest that SLE should be suspected in any HUS patient presenting with hemolytic anemia, thrombocytopenia, acute renal failure and hypocomplementemia, and the therapeutic response and prognosis for SLE with HUS are good.
© 2002 S. Karger AG, Basel
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References
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Kaplan BS, Meyers KE, Schulman SL: The pathogenesis and treatment of hemolytic uremic syndrome. Kidney Int 1988;32:292–308.
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Gasser C, Gautier E, Steck A, Siebenmann RE, Oechslin R: Hämolytisch-urämische Syndrome: Bilaterale Nierenrindennekrosen bei akuten erworbenen hämolytischen Anämien. Schweiz Med Wochenschr 1955;85:905–909.
External Resources
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Jennette JC, Olson JL, Schwartz MM, Silva FG: Hemolytic-uremic syndrome; in Laszik Z, Silva FG (eds): Heptinstall’s Pathology of the Kidney, ed 5. Philadelphia, Lippincott-Raven, 1998, vol 2, pp 1003–1057.
- Johnsson OG, Fink CW: Systemic lupus erythematosus presenting as thrombotic thrombocytopenic purpura. J Rheumatol 1990;17:973–974.
- Nesher G, Hanna VE, Moore TL, Hersh M, Osborn TG: Thrombotic microangiopathic hemolytic anemia in systemic lupus erythematosus. Semin Arthritis Rheum 1994;24:165–172.
- Banfi G, Bertani T, Boeri V, Farggiani T, Mazzucco G, Sacchi G: Renal vascular lesions as a marker of poor prognosis in patients with lupus nephritis. Am J Kidney Dis 1991;18:240–248.
- Ogawa T, Arai H, Maruyama K, Watanabe T, Kobayashi Y, Kikuchi O, Morikawa A: Association of systemic lupus erythematosus and hemolytic uremic syndrome in a child. Pediatr Nephrol 2000;14:62–64.
- Al Shohaib S, Karsou S, Al Ghamdi S: Hemolytic-uremic syndrome superimposed on chronic lupus nephritis. Nephron 2000;86:380.
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Tsao CH, Hsueh S, Huang JL: Initial presentation of hemolytic uremic syndrome in a boy with systemic lupus erythematosus. Rheumatol Int 2002;21:161–164.
Article / Publication Details
Received: October 02, 2001
Accepted: June 11, 2002
Published online: October 07, 2002
Issue release date: September – December
Number of Print Pages: 5
Number of Figures: 2
Number of Tables: 3
ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)
For additional information: https://www.karger.com/AJN
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