Neslihan Yücel, Ender Gedik, Türkan Toğal, Kalender Karahan, Taylan Şahin, Erdinç Koca

Erişkin Akut Böbrek Yetmezliğinin Bir Sebebi Olarak Hemolitik Üremik Sendrom

Trombotik mikroanjiopati, mikroanjiopatik hemolitik anemi, trombositopeni ve çeşitli organ tutulumları ile karekterize mikrovasküler bir hastalıktır. Trombotik mikroanjiopati’de beyin veya böbrek tutulumunun ciddiyetine göre; patolojik olarak benzer, ancak klinik olarak farklı iki klinik tablo tarif edilmiş olup; bunlar trombotik trombositopenik purpura ve hemolitik üremik sendrom olarak adlandırılmıştır. Trombotik trombositopenik purpura daha çok erişkinlerde görülmektedir, nörolojik bulgular ön plandadır ve böbrek tutulumu hafiftir. Buna karşın hemolitik üremik sendrom, daha çok çocukluk çağında görülür, akut böbrek yetmezliği belirleyici özellik olup, nörolojik bulgular hafif veya yoktur. Bu olgu sunumunda erişkin akut böbrek yetmezliği gelişen trombotik mikroanjiopatiye bağlı hemolitik üremik sendromun klinik bulguları, tanısı, patofizyolojisi ve tedavisi tartışılmıştır.

Hemolytic Uremic Syndrome as a Cause of Adult Acute Renal Failure

Thrombotic microangiopathy is a microvascular occlusive disorder characterized bymicroangiopathic hemolytic anemia, thrombocytopenia, and variable signs of organinjury due to platelet thrombosis in the microcirculation. Regarding to the severe ofbrain or renal lesions, two clinical entities (pathologically similar but clinically different)are described: thrombotic thrombocytopenic purpura and hemolytic uremic syndrome.Thrombotic thrombocytopenic purpura usually affect adults, and is characterized bysevere neurologic involvement in most cases, and variable renal involvement. Hemolyticuremic syndrome occurs in young children, and is characterized by acute renal failure,and absent or minimal neurologic abnormalities. In this case report, the clinical features,diagnosis, pathophysiology, and treatment of an adult with acute renal failure due to thethrombotic microangiopathy with hemolytic uremic syndrome are discussed

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