Abstract
Non-Shiga-like toxin-producing Escherichia coli (STEC) or atypical hemolytic uremic syndrome (aHUS) is observed in 5-10% of all hemolytic uremic syndrome (HUS) cases, and usually develops secondary to infections, malignancies, drugs, transplantation, pregnancy, and autoimmune disease. However, there has been no report on adult onset HUS initiated by surgical procedures except transplantation. We report a 66-year-old woman who incurred renal impairment on the first day after laparoscopic hemicolectomy. Hemolytic anemia, thrombocytopenia, absence of Shiga toxin associated disease, normal ADAMTS13 activity, and low serum C3 (not C4) were consistent with a diagnosis of aHUS. We performed plasma exchange with fresh frozen plasma. Nevertheless, deteriorated renal function was not recovered after the treatment. Although it is an uncommon postoperative complication, aHUS needs to be considered as a possible cause of acute kidney injury combined with thrombocytopenia and anemia after surgical procedures, considering its different treatment modality and poor outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 725-728 |
| Number of pages | 4 |
| Journal | Renal Failure |
| Volume | 35 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2013 May 22 |
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Keywords
- Acute kidney injury
- Atypical hemolytic uremic syndrome
- Laparoscopic hemicolectomy
- Thrombotic microangiopathy
ASJC Scopus subject areas
- Nephrology
- Critical Care and Intensive Care Medicine
Cite this
Postoperative hemolytic uremic syndrome with renal cortical necrosis following laparoscopic hemicolectomy. / Lee, Jae Won; Won, Nam Hee; Cho, Eunjung; Kim, Myung-Gyu; Jo, Sang Kyung; Cho, Won Yong; Kim, Hyoung Kyu.
In: Renal Failure, Vol. 35, No. 5, 22.05.2013, p. 725-728.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Postoperative hemolytic uremic syndrome with renal cortical necrosis following laparoscopic hemicolectomy
AU - Lee, Jae Won
AU - Won, Nam Hee
AU - Cho, Eunjung
AU - Kim, Myung-Gyu
AU - Jo, Sang Kyung
AU - Cho, Won Yong
AU - Kim, Hyoung Kyu
PY - 2013/5/22
Y1 - 2013/5/22
N2 - Non-Shiga-like toxin-producing Escherichia coli (STEC) or atypical hemolytic uremic syndrome (aHUS) is observed in 5-10% of all hemolytic uremic syndrome (HUS) cases, and usually develops secondary to infections, malignancies, drugs, transplantation, pregnancy, and autoimmune disease. However, there has been no report on adult onset HUS initiated by surgical procedures except transplantation. We report a 66-year-old woman who incurred renal impairment on the first day after laparoscopic hemicolectomy. Hemolytic anemia, thrombocytopenia, absence of Shiga toxin associated disease, normal ADAMTS13 activity, and low serum C3 (not C4) were consistent with a diagnosis of aHUS. We performed plasma exchange with fresh frozen plasma. Nevertheless, deteriorated renal function was not recovered after the treatment. Although it is an uncommon postoperative complication, aHUS needs to be considered as a possible cause of acute kidney injury combined with thrombocytopenia and anemia after surgical procedures, considering its different treatment modality and poor outcomes.
AB - Non-Shiga-like toxin-producing Escherichia coli (STEC) or atypical hemolytic uremic syndrome (aHUS) is observed in 5-10% of all hemolytic uremic syndrome (HUS) cases, and usually develops secondary to infections, malignancies, drugs, transplantation, pregnancy, and autoimmune disease. However, there has been no report on adult onset HUS initiated by surgical procedures except transplantation. We report a 66-year-old woman who incurred renal impairment on the first day after laparoscopic hemicolectomy. Hemolytic anemia, thrombocytopenia, absence of Shiga toxin associated disease, normal ADAMTS13 activity, and low serum C3 (not C4) were consistent with a diagnosis of aHUS. We performed plasma exchange with fresh frozen plasma. Nevertheless, deteriorated renal function was not recovered after the treatment. Although it is an uncommon postoperative complication, aHUS needs to be considered as a possible cause of acute kidney injury combined with thrombocytopenia and anemia after surgical procedures, considering its different treatment modality and poor outcomes.
KW - Acute kidney injury
KW - Atypical hemolytic uremic syndrome
KW - Laparoscopic hemicolectomy
KW - Thrombotic microangiopathy
UR - http://www.scopus.com/inward/record.url?scp=84877854769&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877854769&partnerID=8YFLogxK
U2 - 10.3109/0886022X.2013.780978
DO - 10.3109/0886022X.2013.780978
M3 - Article
C2 - 23560430
AN - SCOPUS:84877854769
VL - 35
SP - 725
EP - 728
JO - Renal Failure
JF - Renal Failure
SN - 0886-022X
IS - 5
ER -