Atypical hemolytic uremic syndrome in human immunodeficiency virus-1-infected children |
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| Authors: | Mary Ellen Turner Kanwal Kher Tamara Rakusan Lawrence D’Angelo Sudesh Kapur Dena Selby Patricio E. Ray |
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| Affiliation: | (1) Department of Nephrology, Children’s National Medical Center and The George Washington University, Washington, District of Columbia, USA, US;(2) Department of Special Immunology, Children’s National Medical Center and The George Washington University, Washington, District of Columbia, USA, US;(3) Department of Adolescent Medicine, Children’s National Medical Center and The George Washington University, Washington, District of Columbia, USA, US;(4) Department of Pathology, Children’s National Medical Center and The George Washington University, Washington, District of Columbia, USA, US;(5) Children’s Research Institute, Children’s National Medical Center and The George Washington University, Washington, District of Columbia, USA, US |
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| Abstract: | We describe the clinical and pathological findings of the hemolytic uremic syndrome (HUS) in two children with human immunodeficiency virus (HIV) infection. Both patients presented with microangiopathic hemolytic anemia, thrombocytopenia, and subsequently developed renal failure. The diagnosis of HUS was confirmed by renal histopathology in both patients. None of these children presented with bloody diarrhea, evidence of circulating antibody response to Escherichia coli O157 lipopolysaccharide, or other known risk factors for HUS, except for the presence of HIV infection. Each patient was treated with intravenous plasma infusion and renal replacement therapy. Their clinical course was characterized by non-oliguria and lack of significant hypertension throughout the acute phase of the disease. Despite these favorable clinical parameters, both patients developed end-stage renal failure. The etiology of this atypical HUS characterized by poor renal survival remains unknown and the role of HIV infection in its pathogenesis, although possible, is unclear. Received March 5, 1996; received in revised form and accepted October 15, 1996 |
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| Keywords: | : Hemolytic uremic syndrome Human immunodeficiency virus Thrombotic thrombocytopenia Acute renal failure Chronic renal failure |
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