Renal transplantation after Streptococcus pneumoniae-associated hemolytic uremic syndrome.
Of the several causes of nondiarrheal hemolytic uremic syndrome (HUS), infection with Streptococcus pneumoniae is infrequent, but important, because of its unique pathogenesis. A comprehensive literature review found 37 well-documented cases of S pneumoniae-associated HUS (SP-HUS), only 2 of which progressed to end-stage renal disease (ESRD). We report the third such child, and the first to receive a renal transplant following SP-HUS. Her course illustrates several unique characteristics of SP-HUS common to previous patients reported in the literature, including a greater duration of oligoanuria compared with cases not progressing to ESRD, the significant adverse effect of unwashed blood products, and a possible influence of female gender on outcome. Clinicians caring for children with SP-HUS should be aware of these differences and modify therapy appropriately to avoid known risk factors for poor outcome, specifically the use of unwashed blood products.
Krysan
D J
DJ
Department of Pediatrics and Communicable Diseases and the Division of Pediatric Nephrology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA.
Flynn
J T
JT
D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation; D011008:Pneumococcal Infections / Q000150:complications*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification