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American Journal of Medical Case Reports. 2015, 3(9), 278-281
DOI: 10.12691/AJMCR-3-9-4
Case Report

A Case Report of Atypical Hemolytic Uremic Syndrome Presenting with Massive Proteinuria

Rabia Akhtar1 and Diane Triolo2,

1Department of Internal Medicine, St. Joseph’s Regional Medical Center, New York Medical College

2Division of Nephrology, Department of Internal Medicine, St. Joseph’s Regional Medical Center

Pub. Date: July 28, 2015

Cite this paper

Rabia Akhtar and Diane Triolo. A Case Report of Atypical Hemolytic Uremic Syndrome Presenting with Massive Proteinuria. American Journal of Medical Case Reports. 2015; 3(9):278-281. doi: 10.12691/AJMCR-3-9-4

Abstract

Atypical hemolytic uremic syndrome (HUS) is most commonly due to dysregulation of the alternative complement pathway. It is characterized by the classic triad of hemolytic anemia, thrombocytopenia, and acute kidney injury. Treatment includes supportive care including hemodialysis along with steroids, plasmapheresis, and eculizumab. We report a case of a 22 year old female who was diagnosed with atypical HUS and was also noted to have a severe degree of proteinuria, nearly 24 grams in the 24 hour urine collection. Proteinuria is observed in cases of atypical HUS because of the glomerular leakage of protein due to severe endothelial and epithelial injury. However, there is little data directly addressing the degree of proteinuria observed in these patients. This leads us to ask whether the degree of proteinuria has any prognostic significance or impact on disease progression and recovery.

Keywords

atypical hemolytic uremic syndrome, Eculizumab, proteinuria

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Loirat C, Frémeaux-Bacchi V. Atypical hemolytic uremic syndrome. Orphanet Journal of Rare Diseases 2011; 6:60.
 
[2]  Barbour T, Johnson S, Cohney S, et al. Thrombotic microangiopathy and associated renal disorders. Nephrol Dial Transplant 2012; 27(7):2673-85.
 
[3]  Noris M, Remuzzi G. Disease of the Month: Hemolytic Uremic Syndrome. J Am Soc Nephrol 2005; 16(4):1035-1050.
 
[4]  Tsai HM. Thrombotic thrombocytopenic purpura and the atypical hemolytic uremic syndrome: an update. Hematol Oncol Clin North Am 2013; 27:565-584.
 
[5]  Feng S, Eyler S, Zhang Y, et al. Partial ADAMTS13 deficiency in atypical hemolytic uremic syndrome. Blood 2013; 122(8):1487-1493.
 
[6]  Waters AM, Licht C. aHUS caused by complement dysregulation: new therapies on the horizon. Pediatric Nephrology 2011; 26(1):41-57.
 
[7]  Malla K, Mallat T, Hanif M. Prognostic Indicators in Haemolytic Uraemic Syndrome. Kathmandu Univ Med J 2004; 2(4):291-296.
 
[8]  Menon M, Chuang P, He CJ. The Glomerular Filtration Barrier: Components and Crosstalk. International Journal of Nephrology 2012.
 
[9]  Noris M, Mele C, Remuzzi G. Podocyte dysfunction in atypical haemolytic uraemic syndrome. Nat Rev Nephrol 2015.
 
[10]  Eremina V, Jefferson JA, Kowalewska J, et al. VEGF Inhibition and Renal Thrombotic Microangiopathy. The New England Journal of Medicine 2008; 358(11):1129-1136.
 
[11]  Milford DV, White RH, Taylor CM. Prognostic significance of proteinuria one year after onset of diarrhea-associated hemolytic-uremic syndrome. J Pediatr 1991; 118(2):191-4.
 
[12]  Garg AX, Suri RS, Barrowman N, et al. Long-term Renal Prognosis of Diarrhea-Associated Hemolytic Uremic Syndrome: A Systematic Review, Meta-analysis, and Meta-regression. JAMA. 2003; 290(10):1360-1370.
 
[13]  Lou-Meda R, Oakes RS, Gilstrap JN, et al. Prognostic significance of microalbuminuria in postdiarrheal hemolytic uremic syndrome. Pediatr Nephrol 2007; 22(1):117-120.