Consanguineous hemolytic uremic syndrome secondary to Escherichia coli O157 : H7 infection treated with aggressive therapeutic plasma exchange

We describe the successful management of an elderly husband and wife with E scherichia coli O157:117 associated hemolytic uremic syndrome (HUS) treated with aggressive therapeutic plasma exchange (TPE) with replacement with fr esh frozen plasma, Following twelve TPEs (three 1.5 volume; nine 1 volume), the husband's platelet count increased from 45 x 10(9)/L to 183 x 10(9)/L. Following ten 1.5 volume TPEs, the wife's platelet count increased from 30 x 10(9)/L to 193 x 10(9)/L. This is the first known occurrence of E. coil O157:117 associated HUS in an elderly husband and wife successfully treated with aggressive TPE. We conclude that early, aggressive TPE should be cons idered and may be life-saving for E coli O157:117 associated HUS in the eld erly. (C) 2001 Wiley-Liss, Inc.