HEMOLYTIC-UREMIC SYNDROME WITHOUT HEMOLYTIC-ANEMIA - A CASE-REPORT

Hemolytic uremic syndrome (HUS) is characterized by microangiopathic h emolytic anemia, thrombocytopenia and acute renal failure. Most cases of HUS are caused by E. coli 0157:H7 verotoxin. In the case reported h ere, diarrhea continued for twenty days after an E. coli 0157:H7 infec tion and was followed by acute renal failure and thrombocytopenia. Exa mination of percutaneous renal biopsy tissue showed typical HUS findin gs, e.g., mesangiolysis in glomeruli and thickening of capillary walls with prominent double outlines, but there was no indication of hemoly tic anemia. LDH and haptoglobin, indications of hemolytic anemia, were in the normal range throughout the patient's clinical course. The pat ient's red blood cells had P1 antigen, which reportedly provides prote ction by adsorption of toxin into the red blood cells thereby preventi ng or limiting toxic damage to other organs. Therefore, we assumed tha t because of the expression of P1 antigen in this patient, the kidneys were not severely damaged and microangiopathic hemolytic anemia was t hereby avoided.