Apparent Recurrence of Hemolytic Uremic Syndrome in Azathioprine-Treated Allograft Recipients

Griñó, J. M.; Caralps, A; Carreras, L; Nogués, Rosa; Castelao, Alberto Martínez; Romero, R.; Carreras, Marta; Alsina, J

doi:10.1159/000185080

Cited by 19 publications

(5 citation statements)

References 12 publications

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“…‘Recurrent’ HUS was preceded by evident rejection in 3 additional patients who were not treated with CsA [37], 1 of whom died. After the advent of CsA, rejection was believed to be the triggering factor in only one report [9]in which 10 cases were described.…”

Section: Discussionmentioning

confidence: 99%

“…Plasma exchange was performed in 56 episodes of 48 patients [3, 6, 9, 10, 11, 16, 22, 23, 25, 26, 28, 29, 37, 43, 44, 45, 46, 47, 48, 49, 50](table 2). The graft survival rate did not differ significantly between the patients treated with and without plasma exchange (54 vs. 53%).…”

Section: Discussionmentioning

confidence: 99%

“…The graft survival rate did not differ significantly between the patients treated with and without plasma exchange (54 vs. 53%). None of the patients who received plasma exchange died, whereas 12 of 108 patients never treated with plasma exchange died of HUS or associated complications [6, 17, 27, 35, 36, 37]. The lack of controlled studies makes it difficult to evaluate the efficacy of this treatment modality.…”

Section: Discussionmentioning

confidence: 99%

“…Therapy with antiplatelet agents [19, 51, 52, 53]and heparin [27, 34, 35, 37]gave variable results. In an uncontrolled study [4], combined therapy with antiplatelet, anticytokine, and renovasodilator agents yielded a 92% (12/13) graft survival rate, an encouraging result.…”

Section: Discussionmentioning

confidence: 99%

“…Graftectomy is considered to be a rescue procedure for patients in critical conditions despite intensive medical treatment. It has been reported that life-threatening thrombocytopenia and microangiopathic hemolytic anemia disappeared immediately after graftectomy [7, 15, 26, 27, 33, 37]. …”

Section: Discussionmentioning

confidence: 99%

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Hemolytic Uremic Syndrome Associated with Influenza A Virus Infection in an Adult Renal Allograft Recipient: Case Report and Review of the Literature

Asaka¹,

Ishikawa²,

Nakazawa³

et al. 2000

Nephron

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Hemolytic uremic syndrome (HUS) is a rare but serious complication following renal transplantation. It usually develops early after transplantation, and ciclosporin treatment is the most common triggering factor. We report the case of a 35-year-old male with posttransplant HUS which developed 1 year after renal transplantation. He became febrile 4 days before the onset of HUS, and the significant rise in viral titer confirmed the diagnosis of influenza A virus infection. The association of ciclosporin treatment with HUS was unlikely, because of the late onset of HUS and the low ciclosporin trough levels. The patient was treated successfully without a dose reduction of ciclosporin. An etiologic relationship between influenza A virus and HUS was highly probable in our patient. We also review a total of 156 adult cases with HUS after renal transplantation described in the literature. The prognosis of posttransplant HUS differs according to the cause. The advent of ciclosporin has improved the graft survival rate and mortality of patients with rejection-induced HUS.

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Section: Discussionmentioning

confidence: 99%