title: Pandemic H1N1 influenza A viral infection complicated by atypical hemolytic uremic syndrome and diffuse alveolar hemorrhage.
abstract: We report here on a case of a 27-year-old man with atypical hemolytic uremic syndrome and diffuse alveolar hemorrhage associated with influenza A H1N1 infection. Treatment with oseltamivir, plasma exchange and hemodiafiltration for the hemolytic uremic syndrome and meticulous supportive care with steroid pulse therapy for the pulmonary alveolar hemorrhage was successful in this case. We discuss the relationship between hemolytic uremic syndrome and influenza A and the underlying immunologic factors that should be tested in a patient with atypical hemolytic uremic syndrome. We also discuss using steroid therapy for patients with H1N1-related diffuse alveolar hemorrhage.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Pusan National University Hospital, Gudeok-ro 305, Seo-gu, Busan 602-739, Republic of Korea.
authors.forename: Harin
authors.initials: H
authors.lastname: Rhee
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Song
authors.forename: Yong Jae
authors.initials: YJ
authors.lastname: Lee
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Choi
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Ahn
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Seong
authors.forename: Soo Bong
authors.initials: SB
authors.lastname: Lee
authors.forename: Ihm Soo
authors.initials: IS
authors.lastname: Kwak
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D065766:Atypical Hemolytic Uremic Syndrome; D017583:Hemodiafiltration; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D006470:Hemorrhage / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000472:pathogenicity*; D007251:Influenza, Human / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy / Q000821:virology*; D008171:Lung Diseases / Q000175:diagnosis / Q000628:therapy / Q000821:virology*; D008297:Male; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics; D010951:Plasma Exchange; D020551:Pulse Therapy, Drug; D056910:Republic of Korea / Q000453:epidemiology; D013256:Steroids / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D013256:Steroids; D053139:Oseltamivir