Abstract | BACKGROUND: CASES: We highlight three cases of acute transplant dysfunction in which transplant biopsy revealed HUS without associated clinical or hematologic clues to the etiology. Two cases had recurrent HUS and 1 had de novo HUS secondary to tacrolimus therapy. Screenings for ADAMTS-13 and gene mutations of complement regulatory proteins were negative. Thrombocytopenia and red blood cell fragments on blood film appeared some days later. TREATMENT: Treatment comprised a combination of plasma exchange with fresh-frozen plasma and switching immunosuppressive therapy, which led to the recovery of the above hematologic features but salvaged graft function in only 1 case. CONCLUSIONS: Classical hematologic findings of HUS appeared late in these cases. HUS should be considered in cases of allograft dysfunction where there is no obvious cause, and biopsy should be performed. This enables early initiation of therapy to gain rapid recovery of hematologic parameters and potentially of transplant function.
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Authors | M N Ali, M N A Ali, A Syed, A B Syed, S Bhandari, S C Bhandari |
Journal | Transplantation proceedings
(Transplant Proc)
Vol. 45
Issue 9
Pg. 3284-8
(Nov 2013)
ISSN: 1873-2623 [Electronic] United States |
PMID | 24182801
(Publication Type: Case Reports, Journal Article)
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Copyright | Copyright © 2013 Elsevier Inc. All rights reserved. |
Chemical References |
- Immunosuppressive Agents
- Tacrolimus
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Topics |
- Adolescent
- Adult
- Female
- Hemolytic-Uremic Syndrome
(physiopathology)
- Humans
- Immunosuppressive Agents
(administration & dosage)
- Kidney Transplantation
- Male
- Tacrolimus
(administration & dosage)
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