Cihangir AKGÜN, Mehmet Selçuk BEKTAŞ, Mehmet AÇIKGÖZ, FESİH AKTAR, Hayrettin TEMEL, Avni KAYA

Uzamış periton dializi uygulanan hemolitik üremik sendrom olgusu

Hemolitik üremik sendrom; hemolitik anemi, trombositopeni ve akut renal yetmezlik ile karakterize klinik bir tablodur. İnfant ve çocuklarda akut böbrek yetmezliğinin en sık nedenlerinden biridir. Altta yatan patoloji sıklıkla kapillerlerin, daha az sıklıkla arterlerin mikrovasküler tıkayıcı bozukluğu ile giden trombotik mikroanjiyopatisidir. Bu yazıda ateş, kanlı ishal, kusma, idrar renginde koyulaşma ve idrar yapamama şikayetleri ile getirilen yedi aylık erkek olgu sunuldu. 10 gün toplam 240 seans periton dializi sonucunda olgu total anüriden çıktı. Bu olgu Hemolitik üremik sendromlu hastalarda anüriden çıkana kadar periton dializine devam edilmesi gerektiğini vurgulamak amacıyla sunuldu.

Hemolytic uremic syndrome with applied elongated peritoneal dialysis theraphy

Hemolytic uremic syndrome is characterized by the manifestation of hemolytic anemia, thrombocytopenia and acute renal failure. It is the one of the most common cause of acute renal failure in infant and children. Microvascular occlusive outgoing with thrombotic microangiopathy frequently with capillaries and less often with arterial is underlying pathology. In this article, we presented a 7-month-old boy with the complaints of fever, bloody diarrhea, vomiting, darkening of urine color and anuria. As a result of peritoneal dialysis in a duration of 10 days totally 240 seance, patient was get off from anuria. This case was reported to emphasize the patients with Hemolytic uremic syndrome should be continued peritoneal dialysis until get off anuria.

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1) Halevy D, Radhakrishan J, Markowitz G, et al. Thrombotic microangiopathies. Crit Care Clin 2002; 18: 309-320.
2) Katz J, Lurie A, Kaplan B, et al. Coagulation findings in the hemolytic-uremic syndrome of infancy. J Pediatr 1971; 78: 426-434.
3) Leonard M, Ruchelli E, Kaplan B. The pathogenesis of typical diarrhea-associated, hemolytic uremic syndrome. In: Andreucci V, Fine L, eds. International Yearbook of Nephrology. London: Springer-Verlag, 1993; 199-216.
4) Newburg D, Chaturvedi P, Lopez E, et al. Susceptibility to hemolytic-uremic syndrome relates to erythrocyte glycosphingolipid patterns. J Infect Dis 1993; 168: 476-479.
5) Warwicker P, Goodship TH, Donne RL, et al. Geneticstudies in inherited and sporadic haemolytic uremic syndrome. Kidney Int 1998; 53: 836-844.
6) Mahan JD. Hemolytic uremic syndrome. In: Clinical Pediatric Nephrology. Kher K, Schnaper HW and Makker SP (eds). 2007; 235-244.
7) Andreoli SP and Zimmerhacki LB. Hemolytic uremic syndrome. In: Comprehensive pediatric nephrology. Geary DF and Schaefer F. eds. 2008; 359-384.
8) Siegler RL. The hemolytic uremic syndrome. Pediatr Clin North Am. 1995; 42: 1505-1529.
9) Bonilla-Félix M. Peritoneal dialysis in the pediatric intensive care unit setting. Perit Dial Int. 2009; 29 Suppl 2: 183-185.
10) Trompeter R, Schwartz R, Chantler C, et al. Haemolytic-uremic syndrome: an analysis of prognostic features. Arch Dis Child 1983; 58: 101-105.
11) Damme-Lombaerts RV, Proesmans W, Damme BV, et al. Heparin plus dipyridamole in childhood hemolytic-uremic syndrome. A prospective, randomized controlled trial. Pediatr Nephrol 1988; 113: 913-918.
12) Powell HR, McCredie DA, Taylor CM, Burke JR, Walker RG. Vitamin E treatment of haemolytic uraemic syndrome. Arch Dis Child 1984; 59: 401-404.
13) O'Regan S, Chesney RW, Kaplan BS, Drummond KN. Red cell membrane phospholipid abnormalities in the hemolytic uremic syndrome. Clin Nephrol 1981; 15: 14-17.
14) Gagnadoux MF, Habib R, Gubler MC, et al. Long-Term (15-25 Years) Outcome Of Childhood Hemolytic-Uremic Syndrome. Clin Nephrol 1996; 46: 39-41.
15) Steiner M, Anastaso J. Vitamin E, an inhibitor of the platelet release reaction. J Clin Invest 1976; 57: 732-737.