title: Haemolytic-uraemic syndrome during severe lupus nephritis: efficacy of plasma exchange.
abstract: Systemic lupus erythematosus (SLE) has been described as a cause of thrombotic microangiopathy, especially thrombotic thrombocytopenic purpura (TTP). Haemolytic-uraemic syndrome (HUS) is less frequent in SLE. We report a case of such an association during an episode of severe lupus nephritis in a young woman, who was successfully treated with steroids, cyclophosphamide and especially plasma exchange with plasma replacement. This report highlights the importance of recognising atypical HUS in SLE patients by looking for schistocytes in case of haemolytic anemia with a negative antiglobulin test, in order to begin plasma exchange.
authors.affiliation: Department of Internal Medicine and Clinical Immunology, Dijon University Hospital, Dijon, France. samsonmaxime@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Samson
authors.forename: S
authors.initials: S
authors.lastname: Audia
authors.forename: V
authors.initials: V
authors.lastname: Leguy
authors.forename: S
authors.initials: S
authors.lastname: Berthier
authors.forename: N
authors.initials: N
authors.lastname: Janikashvili
authors.forename: L
authors.initials: L
authors.lastname: Martin
authors.forename: B
authors.initials: B
authors.lastname: Bonnotte
authors.forename: B
authors.initials: B
authors.lastname: Lorcerie
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D001706:Biopsy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004913:Erythrocytes, Abnormal; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology; D008181:Lupus Nephritis / Q000150:complications* / Q000188:drug therapy; D008775:Methylprednisolone / Q000627:therapeutic use; D018448:Models, Immunological; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010951:Plasma Exchange; D011241:Prednisone / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D006886:Hydroxychloroquine; D003520:Cyclophosphamide; D009173:Mycophenolic Acid; D011241:Prednisone; D008775:Methylprednisolone