Dj. Krysan et Jt. Flynn, Renal transplantation after Streptococcus pneumoniae-associated hemolytic uremic syndrome, AM J KIDNEY, 37(2), 2001, pp. NIL_83-NIL_90
Of the several causes of nondiarrheal hemolytic uremic syndrome (HUS), infe
ction with Streptococcus pneumoniae is infrequent, but important, because o
f its unique pathogenesis. A comprehensive literature review found 37 well-
documented cases of S pneumoniae-associated HUS (SP-HUS), only 2 of which p
rogressed to end-stags renal disease (ESRD). We report the third such child
, and the first to receive a renal transplant following SP-HUS. Her course
illustrates several unique characteristics of SP-HUS common to previous pat
ients reported in the literature, including a greater duration of oligoanur
ia compared with cases not progressing to ESRD, the significant adverse eff
ect of unwashed blood products, and a possible influence of female gender o
n outcome. Clinicians caring for children with SP-HUS should be aware of th
ese differences and modify therapy appropriately to avoid known risk factor
s for poor outcome, specifically the use of unwashed blood products. (C) 20
01 by the National Kidney Foundation, Inc.