Atypical relapse of hemolytic uremic syndrome after transplantation View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2004-08-05

AUTHORS

Karolien H. Olie, Sandrine Florquin, Jaap W. Groothoff, René Verlaak, Lisa Strain, Timothy H. J. Goodship, Jan J. Weening, Jean-Claude Davin

ABSTRACT

Atypical hemolytic uremic syndrome (HUS) frequently leads to end-stage renal failure and can relapse after transplantation. A 12-year-old girl presenting with familial atypical HUS with a factor H mutation was successfully transplanted 6 years after a first transplant that had failed because of immediate recurrent HUS. Prophylactic plasma exchange before and after transplantation was used. Two months after transplantation, concomitant with a reduction in plasma exchange frequency, the plasma creatinine increased from 70 µmol/l to 194 µmol/l in 2 weeks without thrombocytopenia or signs of hemolytic anemia. The patient had minimal clinical symptoms and a presumptive diagnosis of graft rejection was made. Despite treatment with six daily pulses of methylprednisolone, plasma creatinine continued to increase and a graft biopsy was therefore undertaken. This showed the typical appearance of a thrombotic microangiopathy without any evidence of rejection. Despite daily plasmapheresis and replacement of cyclosporine with tacrolimus, there was no improvement and transplant nephrectomy was undertaken. This patient demonstrates that HUS can recur in a kidney transplant without the diagnostic hematological features and emphasizes the need for early transplant biopsy in such patients showing a decline in transplant function. More... »

PAGES

1173-1176

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00467-004-1565-2

DOI

http://dx.doi.org/10.1007/s00467-004-1565-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1036742435

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/15300478


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