Hemolytic uremic syndrome in a child with leukemia and cytomegalovirus infection

A 2-year-old boy had a severe cytomegalovirus (CMV) infection with multi-or gan involvement, while on maintenance therapy for acute lymphoblastic leuke mia. The patient was treated with intravenous gancyclovir, with a marked im provement in his clinical status, with the exception of a progressive deter ioration of the renal function. He also developed hemolytic anemia and thro mbocytopenia, suggesting a diagnosis of atypical hemolytic uremic syndrome (HUS). A percutaneous renal biopsy showed lesions consistent with HUS, but no evidence of CMV infection. The patient had a good clinical outcome with no evidence of renal sequelae. We report a rare association of CMV infectio n and HUS in the pediatric age-group, which suggests a possible cause-effec t relationship that deserves further evaluation.