Kaan Esen, İclal Gürses, Fatih Özaltın, Emine Korkmaz, Ali Delibaş, Banu Coşkun-Yılmaz, Serra Sürmeli-Döven, Uğur Raşit Kayacan

Hemolytic uremic syndrome and IgA nephropathy in a child: Coincidence or not?

Sürmeli-Döven S, Delibaş A, Gürses İ, Kayacan UR, CoşkunYılmaz B, Esen K, Korkmaz E, Özaltın F. Hemolytic uremic syndrome and IgAnephropathy in a child: Coincidence or not? Turk J Pediatr 2018; 60: 81-85.A previously healthy 18-month old boy, presenting with diarrhea, anemia,thrombocytopenia and acute renal failure was admitted to our hospital.Hemolytic uremic syndrome (HUS) was diagnosed with his clinical andlaboratory findings. His stool was negative for Shiga toxin producing E. coli (STEC).During follow-up he developed respiratory distress, hypertrophic cardiomyopathy andseizure. His genetic tests for atypical HUS (aHUS) were negative. His clinical andhistological findings indicated hemolytic uremic syndrome and immunglobulinA nephropathy (IgAN). The patient responded to steroid treatment andplasma exchange therapy with peritoneal dialysis. We discuss the probableconnection between HUS and IgAN.

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1. Grisaru S. Management of hemolytic-uremic syndrome in children. Int J Nephrol Renovasc Dis 2014; 7: 231-239.
2. Sumiharu M. Sakai T. Okamoto Ni, et al. Hemolytic Uremic Syndrome Associated with Immunglobulin A Nephropathy: A Case Report and Review of Cases of Hemolytic Uremic Syndrome with Glomerular Disease. Intern Med J 1999; 38: 495-499.
3. Chang A, Kowalewska J, Smith KD, Nicosia RF, Alpers CE. A clinicopathologic study of thrombotic microangiopathy in the setting of IgA nephropathy. Clin Nephrol 2006; 66: 397-404.
4. Servais A, Frémeaux-Bacchi V, Lequintrec M, et al. Primary glomerulonephritis with isolated C3 deposits: a new entity which shares common genetic risk factors with haemolytic uraemic syndrome. J Med Genet 2007; 44: 193-199.
5. Pouria S, Barratt J. Secondary IgA nephropathy. Semin Nephrol 2008; 28: 27-37.
6. Emancipator SN. Experimental models of IgA nephropathy. Am J Kidney Dis 1988; 12: 415-419.
7. Wang R, Zhang Y, Li S, et al. Hemolytic uremic syndrome complicated with IgA nephropathy: a case report and literature review. Clin Nephrol 2015; 83: 36-40.
8. Schmitt R, Krmar RT, Kristoffersson A, Söderberg M, Karpman D. IgA nephropathy associated with a novel N-terminal mutation in factor H. Eur J Pediatr 2011; 170: 107-110.
9. Montinaro V, Gesualdo L, Ranieri E. Monno R, Grandaliano G, Schena FP. Renal cortical complement C3 gene expression in IgA nephropathy. J Am Soc Nephrol 1997; 8: 415-425.
10. Micheletti MV, Lavoratti G, Gasperini S, Domnati MA, Pela I. Hemolytic uremic syndrome and rhabdomyolysis in a patient with succinate coenzyme Q reductase (complex II) deficiency. Clin Nephrol 2011; 76: 68-73.
11. Andreoli SP, Bergstein JM. Acute rhabdomyolysis associated with hemolytic-uremic syndrome. J Pediatr 1983; 103: 78-80.
12. Pipili C, Pantelias K, Papaioannou N, Paraskevakou H, Grapsa E. Hemolytic–uremic syndrome, malignant hypertension and IgA nephropathy: Successful treatment with plasma exchange therapy. Transfus Apher Sci 2012; 42: 155-158.