Possible hemolytic uremic syndrome in three cats after renal transplantation and cyclosporine therapy.
OBJECTIVE
To describe the clinical history of 3 cats with possible hemolytic uremic syndrome (HUS) after renal transplantation.


METHODS
This case series documents historical findings, physical examination findings, clinical pathologic features, necropsy and histopathologic findings of 3 cats with possible HUS.


RESULTS
Two cats had chronic renal failure; 1 cat had acute renal failure secondary to ethylene glycol toxicity. A renal transplant was performed in each of the 3 cats without obvious problems. Complications that would support a diagnosis of HUS, including anemia, thrombocytopenia, and azotemia occurred within 24 hours in 1 cat, within 8 days in a second cat, and 2 months after transplantation in the third cat. In 2 cats, HUS was likely secondary to cyclosporine immunosuppression. In the third cat, HUS may have been secondary to allograft rejection. Renal biopsies from all 3 cats were suggestive of HUS.


CONCLUSIONS
In human beings, HUS in transplant recipients may occur secondary to immunosuppressive drugs, vascular rejection, or recurrence of original disease. Graft loss occurred in all 3 cats in this study and the mortality rate was 100%. Clinicians caring for these patients need to be aware of this disorder because early recognition and treatment is critical in the management of post-transplant HUS.
Aronson
L R
LR
Veterinary Medical Teaching Hospital, Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, USA.
Gregory
C
C
D000818:Animals; D002371:Cat Diseases / Q000601:surgery*; D002415:Cats; D016572:Cyclosporine / Q000009:adverse effects*; D005260:Female; D006084:Graft Rejection / Q000662:veterinary; D006463:Hemolytic-Uremic Syndrome / Q000139:chemically induced / Q000503:physiopathology / Q000662:veterinary*; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000601:surgery / Q000662:veterinary*; D016030:Kidney Transplantation / Q000662:veterinary*; D008297:Male
D007166:Immunosuppressive Agents; D016572:Cyclosporine