J Korean Soc Transplant.  1999 Dec;13(2):277-286.

Postrenal Transplantation Cyclosporine Associated Hemolytic Uremic Syndrome in End Stage Renal Failure Patient Caused by Systemic Lupus Erythematosus

Affiliations
  • 1Department of Surgery, College of Medicine, DanKook University, Korea. jkpark@anseo.dankook.ac.kr
  • 2Department of Internal Medicine, College of Medicine, DanKook University, Korea.
  • 3Department of Neurosurgery, College of Medicine, DanKook University, Korea.
  • 4Department of Neurology, College of Medicine, DanKook University, Korea.
  • 5Department of Urology, College of Medicine, DanKook University,
  • 6Department of Pathology, College of Medicine, Seoul National University, Korea.

Abstract

Although the outcome and the possibility of renal recurrence of disease in systemic lupus erythematosus is still a matter of controversy, kidney transplantation is generally regarded as a proper indication for the treatment of patients with end stage renal failure caused by systemic lupus erythematosus. Hemolytic uremic syndrome is characterized by the symptoms of sudden onset of hemolytic anemia, thrombocytopenia, and deteriorating renal function. Many patients with postrenal transplantation hemolytic uremic syndrome have lost their grafts because of no known established treatment modality. Although the substitution of cyclosporine to FK506 is reported as a successful strategy for the treatment of cyclosporine associated hemolytic uremic syndrome in many reported cases, we cannot find the constant reports because FK506 or even OKT3 is also known as the cause of postrenal transplantation hemolytic uremic syndrome. But cyclosporine associated hemolytic uremic syndrome can be treated by the proper choice of immunosuppressant and conservative treatment. In this report, a patient with end stage renal failure caused by systemic lupus erythematosus experienced cyclosporine associated postrenal transplantation hemolytic uremic syndrome. He has recovered from the symptoms by withdrawal of cyclosporine and reduced dose of FK506 and at the same time, conservative treatment. We report this case with literature review.

Keyword

Systemic lupus erythematosus; Cyclosporine; Hemolytic uremic syndrome
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