Consanguineous hemolytic uremic syndrome secondary to Escherichia coli O157:H7 infection treated with aggressive therapeutic plasma exchange.
We describe the successful management of an elderly husband and wife with Escherichia coli O157:H7 associated hemolytic uremic syndrome (HUS) treated with aggressive therapeutic plasma exchange (TPE) with replacement with fresh frozen plasma. Following twelve TPEs (three 1.5 volume; nine 1 volume), the husband's platelet count increased from 45 x 10(9)/L to 183 x 10(9)/L. Following ten 1.5 volume TPEs, the wife's platelet count increased from 30 x 10(9)/L to 193 x 10(9)/L. This is the first known occurrence of E. coli O157:H7 associated HUS in an elderly husband and wife successfully treated with aggressive TPE. We conclude that early, aggressive TPE should be considered and may be life-saving for E coli O157:H7 associated HUS in the elderly.
Downes
K A
KA
Department of Pathology, University Hospitals of Cleveland and Case Western Reserve, 11000 Euclid Avenue Cleveland, Ohio 44106, USA.
Allen
K
K
Sarode
R
R
Yomtovian
R
R
D000368:Aged; D004927:Escherichia coli Infections / Q000097:blood / Q000150:complications* / Q000628:therapy; D019453:Escherichia coli O157; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000209:etiology* / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D008297:Male; D010951:Plasma Exchange; D010976:Platelet Count; D016896:Treatment Outcome