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Consanguineous hemolytic uremic syndrome secondary to Escherichia coli O157:H7 infection

Consanguineous hemolytic uremic syndrome secondary to Escherichia coli O157:H7 infection treated with aggressive therapeutic plasma exchange. Downes KA, Allen K, Sarode R, Yomtovian R. Journal of Clinical Apheresis 2001;16:155-156.

ABSTRACT:

A case report of an elderly couple with E. coli O157H:7 associated hemolytic uremic syndrome (HUS) is presented. The 79 year old male and 75 year old female presented with abdominal pain and bloody diarrhea eight days apart. The man developed acute renal insufficiency, anemia, thrombocytopenia, and mental confusion. When HUS was diagnosed, therapeutic plasma exchange (TPE) was initiated. Over 15 days he had 12 treatments with TPE. At day 31 of hospitalization, his diarrhea had ceased, his blood tests and renal function improved, and his mental status returned to baseline. He was discharged to a nursing home and eventually to home. The woman had a similar history and underwent 10 TPE treatments. Her thrombocytopenia resolved but her mental status continued to fluctuate, perhaps as a consequence of her chronic alcohol abuse. She was discharged to a nursing home on day 27 of hospitalization where she remained, having returned to her baseline mental status. This is the first report of an elderly couple with E. coli-associated HUS successfully treated with aggressive TPE.