title: An unexpected diagnostic course of systemic lupus erythematosus.
abstract: Thrombotic microangiopathy (TM), especially thrombotic thrombocytopenic purpura (TTP) is described in systemic lupus erythematosus (SLE) as a severe hematological involvement. However hemolytic uremic syndrome (HUS) is seen less frequently in SLE, particularly as an initial presentation. Here we present a 15-year old boy presenting with gross hematuria, decreased urinary output and petechial lesions. He was diagnosed as atypical HUS according to the classical triad of TM, along with observation of hypocomplementemia and negative stool cultures. In addition, his symptoms fulfilled the 2012 revised criteria for the classification of SLE. He was treated with plasma infusions and methylprednisolone/prednisone. At follow up his laboratory findings and general condition improved and no relapse was seen.
authors.affiliation: Department of Pediatric Nephrology and Rheumatology, Ankara Child Health, Hematology, Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Aysel
authors.initials: A
authors.lastname: Taktak
authors.affiliation: Department of Pediatric Nephrology and Rheumatology, Ankara Child Health, Hematology, Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Köksoy
authors.affiliation: Department of Pediatric Nephrology and Rheumatology, Ankara Child Health, Hematology, Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Özge
authors.initials: Ö
authors.lastname: Başaran
authors.affiliation: Department of Pathology, Ankara University Faculty of Medicine, Ankara, Turkey.
authors.forename: Saba
authors.initials: S
authors.lastname: Kiremitçi
authors.affiliation: Department of Pediatric Nephrology and Rheumatology, Ankara Child Health, Hematology, Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Banu
authors.initials: B
authors.lastname: Acar
authors.affiliation: Department of Pediatric Nephrology and Rheumatology, Ankara Child Health, Hematology, Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Nermin
authors.initials: N
authors.lastname: Uncu
authors.affiliation: Department of Pediatric Nephrology and Rheumatology, Ankara Child Health, Hematology, Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Nilgün
authors.initials: N
authors.lastname: Çakar
mesh_terms: D000293:Adolescent; D065766:Atypical Hemolytic Uremic Syndrome / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D010949:Plasma / Q000187:drug effects*; D012008:Recurrence
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone
keywords: child; systemic lupus erythematosus; thrombotic microangiopathy