HEMOLYTIC-UREMIC SYNDROME COMPLICATING POSTINFECTIOUS GLOMERULONEPHRITIS IN THE ADULT

Hemolytic uremic syndrome/thrombotic thrombocytopenic purpura is known to occur as a secondary complication of primary renal diseases, speci fically of lupus nephritis, membranous glomerulonephritis, and focal s egmental glomerulosclerosis. In a patient without a family history of hemolytic uremic syndrome/thrombotic thrombocytopenic purpura we obser ved biopsy-confirmed postinfectious glomerulonephritis with humps, wit h simultaneous subendothelial hyaline deposits and fibrinoid thrombi i n arterioles. The patient had a history of febrile pharyngitis with di arrhea 10 days prior to renal biopsy. He presented with transient elev ation of serum creatinine, a nephritic sediment, and hypertension not exceeding 160/100 mm Hg. The patient also had purpura, transient throm bocytopenia, and signs of intravascular hemolysis. Results of verocyto toxin serology were negative. With the exception of isolated microhema turia, all findings reverted to normal within 8 weeks without any spec ific treatment. This case illustrates that hemolytic uremic syndrome/t hrombotic thrombocytopenic purpura may complicate primary postinfectio us glomerulonephritis in adults. (C) 1995 by the National Kidney Found ation, Inc.