Hemolytic-Uremic Syndrome Mimicking Ulcerative Colitis

Dillard, Robert P.

doi:10.1177/000992288302200110

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…At least 20% of patients with primary aHUS experience extra-renal manifestations and approximately 5% of patients develop life-threatening multivisceral failure [ 5 , 20 ]. HUS may present with ischemic colitis and may be misdiagnosed as acute appendicitis or acute UC [ 21 , 22 ]. The present case is unique in that the patient developed aHUS in the course of chronic active UC.…”

Section: Discussionmentioning

confidence: 99%

Atypical Hemolytic Uremic Syndrome and Chronic Ulcerative Colitis Treated with Eculizumab

Webb

Griffiths

Miyashita

et al. 2015

IJMPCR

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BackgroundHemolytic-uremic syndrome (HUS) presents with hemolytic anemia, thrombocytopenia, and thrombotic microangiopathy of the kidney and usually results from Shiga-toxin induced activation of the alternative complement pathway. Gastroenteritis is a common feature of the Shiga-toxin producing Escherichia coli HUS, referred to as STEC-HUS. An inherited or acquired complement dysregulation may lead to HUS referred to as non-STEC or atypical (a)HUS. Although gastroenteritis is not a common presentation of aHUS, some patients develop ischemic colitis and may be misdiagnosed as acute appendicitis or acute ulcerative colitis (UC).Case Diagnosis –TreatmentWe present a patient with low circulating complement (C) 3 levels who developed aHUS in the course of chronic active UC. Resolution of renal and gastrointestinal manifestations in response to treatment with eculizumab, a humanized monoclonal antibody against terminal C5 protein suggests the role of alternative complement in the pathogenesis of both, aHUS and UC.ConclusionThis case illustrates that dysregulation of the alternative complement pathway may manifest in other organs besides the kidney and that the circulating C3 levels do not correlate with the disease activity or the clinical response to eculizumab.

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Section: Discussionmentioning

confidence: 99%

Atypical Hemolytic Uremic Syndrome and Chronic Ulcerative Colitis Treated with Eculizumab

Webb

Griffiths

Miyashita

et al. 2015

IJMPCR

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“…Several reports describing HUS mimicking the symptomatology of inflammatory bowel disease have been published [19][20][21][22]. However, given the pre-existing diagnosis of Crohn's disease in our patient, we believe that "mimicry" is unlikely.…”

Section: Discussionmentioning

confidence: 67%

Devastating Presentations of Regional Enteritis (Crohn's Disease): Two Reports of Survival Following Severe Multiple Organ Dysfunction Syndrome

Grossman¹,

Hydo²,

Wang³

et al. 2004

Surgical Infections

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“…Most patients with hemolytic uremic syndrome present with gastrointestinal manifestations (41,42), including nonbloody or bloody diarrhea, acute colitis, acute abdomen, ischemic bowel, ulcerative colitis, intussusception, or appendicitis (27,34,(41)(42)(43)(44)(45)(46)(47). Hemorrhagic colitis and the bloody diarrhea prodrome of hemolytic uremic syndrome show many similarities (42,44).…”

Section: Hemolytic Uremic Syndromementioning

confidence: 99%

Verotoxic Escherichia coli in Human Disease

Rosensweig,

Gourley

1991

J. pediatr. gastroenterol. nutr.

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SummaryVerotoxin‐producing E. coli (most frequently E. coli 0157) have been implicated in the pathogenesis of diarrhea, hemorrhagic colitis, hemolytic uremic syndrome and thrombotic thrombocytopenic purpura. Cattle, meat products, and other sources have been found to harbor these organisms. Isolation of E. coli 0157:H7 on MacConkey‐sorbitol agar is diagnostic, yet the bacteria are difficult to detect after the first week of infection. Enzyme linked immunosorbent assays (ELISAs) can detect verotoxin in fecal filtrates in the absence of viable bacteria. Serologic evidence has also been used to support the diagnosis of verotoxin‐associated infection. Evidence supporting the etiologic role of different verotox‐ins is reviewed. Treatment remains supportive since the use of antibiotics and antimotility agents can lead to poorer outcomes. Recommendations for prevention are presented.

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Hemolytic-Uremic Syndrome Mimicking Ulcerative Colitis

Cited by 8 publications

References 10 publications

Atypical Hemolytic Uremic Syndrome and Chronic Ulcerative Colitis Treated with Eculizumab

Atypical Hemolytic Uremic Syndrome and Chronic Ulcerative Colitis Treated with Eculizumab

Devastating Presentations of Regional Enteritis (Crohn's Disease): Two Reports of Survival Following Severe Multiple Organ Dysfunction Syndrome

Verotoxic Escherichia coli in Human Disease

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