Korean J Nephrol.  2010 May;29(3):392-397.

A Case of Digital Gangrene Complicated by Atypical Hemolytic Uremic Syndrome in a Patient with Systemic Lupus Erythematosus

Affiliations
  • 1Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea. dr52916@catholic.ac.kr

Abstract

Atypical hemolytic uremic syndrome (HUS) in adults is a life-threatening disorder characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia, which is not related to E. coli. Digital gangrene is one of the grave signs in emergency medicine because it requires prompt evaluation and treatment. We describe a 37 year-old Thailand woman, initially treated for suspected Neisseria septicemia, who went on to develop renal complications, thrombocytopenia and hemolytic anemia, which made the diagnosis of atypical hemolytic uremic syndrome. The patient was complaining of dysesthesia on all extremities and severe pain in both legs. Serologically, she was diagnosed as systemic lupus erythematosus (SLE). She was treated with plasma exchanges using fresh frozen plasma, parenteral steroid, anticoagulant and antibiotics, successfully. This is the first report of digital gangrene complicated by atypical HUS in a patient with SLE in Korea.

Keyword

Gangrene; Hemolytic-Uremic syndrome; Lupus erythematosus; systemic; Sepsis

MeSH Terms

Acute Kidney Injury
Adult
Anemia, Hemolytic
Anti-Bacterial Agents
Emergency Medicine
Extremities
Female
Gangrene
Hemolytic-Uremic Syndrome
Humans
Korea
Leg
Lupus Erythematosus, Systemic
Neisseria
Paresthesia
Plasma
Plasma Exchange
Sepsis
Thailand
Thrombocytopenia
Anti-Bacterial Agents
Hemolytic-Uremic Syndrome
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