title: Streptococcus pneumoniae-associated hemolytic uremic syndrome in a splenectomized adult patient.
abstract: A 62-year-old splenectomized woman was admitted because of upper respiratory tract symptoms, general fatigue, and purpura. Laboratory data demonstrated microangiopathic hemolytic anemia, thrombocytopenia, acute renal failure, and a positive Streptococcus pneumoniae (SP) urinary antigen test. A renal biopsy showed thrombotic microangiopathic changes. She was diagnosed with hemolytic uremic syndrome (HUS) secondary to SP infection. Methylprednisolone pulse therapy in addition to antibiotic therapy led to prompt improvement of her symptoms and laboratory abnormalities. This is the first adult case of SP-associated HUS successfully treated without hemodialysis. SP infection should be considered as a causative etiology in all splenectomized patients with HUS.
authors.affiliation: Department of Internal Medicine, Yuri Kumiai General Hospital, Japan.
authors.forename: Nobuki
authors.initials: N
authors.lastname: Maki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Komatsuda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohtani
authors.forename: Jun
authors.initials: J
authors.lastname: Kuroki
authors.forename: Tamio
authors.initials: T
authors.lastname: Nishinari
authors.forename: Kenichi
authors.initials: K
authors.lastname: Asakura
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sawada
authors.forename: Hideki
authors.initials: H
authors.lastname: Wakui
mesh_terms: D058186:Acute Kidney Injury / Q000188:drug therapy / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D013156:Splenectomy / Q000009:adverse effects*; D013256:Steroids / Q000008:administration & dosage; D057049:Thrombotic Microangiopathies / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents; D013256:Steroids