title: Pneumococcal hemolytic uremic syndrome and steroid resistant nephrotic syndrome.
abstract: Pneumococcal-associated hemolytic uremic syndrome (pHUS) is a rare but severe complication of invasive Streptococcus pneumoniae infection. We report the case of a 12-year-old female with steroid-resistant nephrotic syndrome treated with adrenocorticotrophic hormone (H.P. Acthar(®) Gel), who developed pneumococcal pneumonia and subsequent pHUS. While nephrotic syndrome is a well-known risk factor for invasive pneumococcal disease, this is the first reported case of pHUS in an adolescent patient with nephrotic syndrome, and reveals novel challenges in the diagnosis, treatment and potential prevention of this complication.
authors.affiliation: Washington University School of Medicine , St Louis, MO , USA.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Groves
authors.affiliation: Division of Infectious Disease, Department of Pediatrics , Washington University School of Medicine , St Louis, MO , USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Reich
authors.affiliation: Division of Critical Care Medicine, Department of Pediatrics , Washington University School of Medicine , St Louis, MO , USA.
authors.forename: Binayak
authors.initials: B
authors.lastname: Sigdel
authors.affiliation: Division of Nephrology, Department of Pediatrics , Washington University School of Medicine , St Louis, MO , USA.
authors.forename: T Keefe
authors.initials: TK
authors.lastname: Davis
keywords: Acthar; hemolytic; nephrotic; streptococcus; uremic