title: A diagnosis of haemolytic-uraemic syndrome blurred by alcohol abuse.
abstract: A 60-year-old man with a history of alcohol abuse was admitted to the intensive care unit (ICU) for status epilepticus. At first, laboratory and imagery findings were almost normal, and the symptoms were attributed to severe alcohol withdrawal due to a history of gastroenteritis reported by his family. But, during the following days, haemolytic anaemia, thrombocytopenia, acute renal failure, and ischaemic and haemorrhagic lesions seen on a cerebral CT scan led to the diagnosis of haemolytic-uraemic syndrome (HUS). Despite these severe complications, the patient made a good recovery following ICU and plasma exchange with fresh frozen plasma (FFP), but cognitive deficit still existed after 1 month. It is important to know that neurological manifestations can precede typical biological and radiological signs in HUS, and to not be misled in the diagnosis process, especially when a more common differential diagnosis is possible.
authors.affiliation: Department of Internal Medicine, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Priest-en-Jarez, France.
authors.forename: Martin
authors.identifier: http://orcid.org/0000-0001-7115-3248
authors.initials: M
authors.lastname: Killian
authors.affiliation: Intensive Care Unit, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Priest-en-Jarez, France.
authors.forename: Noémie
authors.initials: N
authors.lastname: Bruel Tronchon
authors.affiliation: Department of Nephrology, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Priest-en-Jarez, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Maillard
authors.affiliation: Intensive Care Unit, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Priest-en-Jarez, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Tardy
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology; D000437:Alcoholism / Q000150:complications; D003937:Diagnosis, Differential; D006463:Hemolytic-Uremic Syndrome / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D013226:Status Epilepticus / Q000175:diagnosis* / Q000209:etiology; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis*