Plasmapheresis in a very young infant with atypical hemolytic uremic syndrome

Atypical hemolytic uremic syndrome (HUS) is a heterogeneous group of disord ers, the pathogenesis of which is unclear. Plasma transfusions and plasmaph eresis are widely used modes of therapy for adults with this life threateni ng syndrome. There is very limited experience in using plasmapheresis thera py in children and infants with atypical HUS. Plasmapheresis, which is cons idered a relatively safe procedure in adults and older children, may be haz ardous in neonates and very young infants and can result in severe complica tions. We report a 2-month-old infant with idiopathic atypical HUS, who was successfully treated with a 1-month course of plasmapheresis during the ac ute phase of the disease. Appropriate preparations as well as several adjus tments were made in order to meet the special needs of this very young infa nt who, to the best of our knowledge, is the youngest reported patient with atypical HUS to undergo plasmapheresis. Plasmapheresis therapy of the infa nt was not associated with any complications of the procedure and resulted in marked clinical improvement. We conclude that plasmapheresis in neonates and in very small infants is technically feasible, can be performed withou t major complications, and may be of benefit in individual cases.