Cerebral infarct with recurrence of hemolytic-uremic syndrome in a child following renal transplantation.
A white girl with a history of atypical hemolytic-uremic syndrome (HUS) and persistent microangiopathic anemia, and thrombocytopenia for 2 months after the initial presentation at age 7 months, received her first cadaveric renal transplant at age 3 years. During the first 2.5 days post transplant, she developed progressive thrombocytopenia and anemia followed by tonic-clonic seizures and loss of consciousness, secondary to a diffuse cerebral infarction of the left hemisphere. Renal histology showed evidence of glomerular microthrombi and microangiopathy. A large cerebral infarct, previously described in patients during their initial presentation with HUS, presented in our patient as part of the recurrence of the disease post renal transplantation.
Mochon
M
M
Department of Pediatrics (Section of Nephrology), St. Christopher's Hospital for Children, Temple University School of Medicine, Philadelphia, Pennsylvania 19134.
Kaiser
B A
BA
deChadarevian
J P
JP
Polinsky
M S
MS
Baluarte
H J
HJ
D002544:Cerebral Infarction / Q000209:etiology* / Q000473:pathology; D002675:Child, Preschool; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000209:etiology* / Q000473:pathology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000473:pathology; D012008:Recurrence