A case of hemolytic-uremic syndrome with the development of catastrophic antiphospholipid syndrome: Diagnosis and clinical tactics

Abstract

The paper describes a case of practically simultaneous development of the hemolytic-uremic syndrome (HUS) and the catastrophic antiphospholipid syndrome (CAPS) complicated by mesenteric vessel thrombosis and small bowel necrosis. Multimodality treatment comprising volume plasmapheresis, fresh frozen plasma transfusion, hemodialysis, anticoagulant and disaggregant therapy could relieve thrombogenic events, such as pulmonary artery thromboembolism and intestinal necrosis.

References

  1. Панков Е. А., Папаян А. В., Куаншкалиев Р. С. Исследование функционального состояния почек в ближайшем и отдаленном катамнезе у детей, перенесших гемолитико-уремический синдром. В кн.: Материалы Всероссийской науч.-практ. конф. "Проблемы детской нефрологии". М.; 1997: 79.
  2. Bielaszewska M., Zhang W., Mellmann A., Karch H. Enterohaemorrhagic Escherichia coli O26:H11/H-: a human pathogen in emergence. Berl. Münch. Tierarztl. Wschr. 2007; 120(7-8): 279-287.
  3. Boyce T. G., Swerdlow D. L., Griffin P. M. Escherichia coli 0157:H7 and the hemolytic uremic syndrome. N. Engl. J. Med. 1995; 333: 364-368.
  4. McRegan S., Chesney R., Kaplan B., Drummond K. Red cell membrane phospholipid abnormalities in the haemolytic uremic syndrome. Clin. Nephrol. 1981; l5: 14-17.
  5. Karch H., Friedrich A. W., Gerber A. et al. New aspects in the pathogenesis of enteropathic hemolytic uremic syndrome. Semin. Thromb. Hemost. 2006; 32(2): 105-112.
  6. Harel Y., Silva M., Giroir B. et al. A reporter transgene indicates renal-specific induction of tumour necrosis factor (TNF) by Shiga-like toxin. J. Clin. Invest. 1993; 92: 2110-2116.
  7. Inward C. D., Varagunam M., Adu D. et al. Cytokines in haemolytic uremic syndrome associated with verocytotoxin-producing Escherichia coli infection. Arch. Dis. Child. 1997; 77; 145-147.
  8. Obrig T. G., Louise C. B., Lingwood C. A. et al. Endothelial heterogeneity in Shiga toxin receptors and responses. J. Biol. Chem. 1993; 268: 15484-15488.
  9. Reid J. L., Dawson D., Macral I. M. Endothelin, cerebral ischemia and infarction. Clin. Exp. Hypertens. 1995; 17: 399- 407.
  10. Kohan D. E. Endothelins in the normal and diseased kidney. Am. J. Kidney Dis. 1997; 29: 2-26.
  11. Kuhn M., Fuchs M., Beck F. et al. Endothelin-1 potently stimulates chloride secretion and inhibits Na(+)-glucose absorbtion in human intestine in vitro J. Physiol. (Lond.). 1996; 499: 391-402.
  12. Turi S., Nemeth I., Vargha I., Matkovics B. Oxidative damage of red blood cells in haemolytic uremic syndrome. Pediatr. Nephrol. 1994; 8: 26-29.
  13. Espinosa G., Bucciarelli S., Cervera R. et al. Thrombotic microangiopathic anemia and antiphospholipid antibodies. Ann. Rheum. Dis. 2004; 63(6): 730-736.
  14. Asherson R. A. The catastrophic antiphospholipid syndrome. (Asherson's syndrome). Johannesburg; 2005.
  15. Asherson R. A., Cervera R., Piette J. C. et al. Catastrophic antiphospholipid syndrome: clues to the pathogenesis from the series of 80 patients. Medicine (Baltimore) 2001; 80(6): 355- 377.
  16. Cervera R., Font J., Gomez-Puerta J. A. et al. Catastrophic antiphospholipid syndrome Registry Project Group. Validation of the preliminary criteria for the classification of catastrophic antiphospholipid syndrome. Ann. Rheum. Dis. 2005; 64: 1205-1209.
  17. del Papa N., Guidali L., Salq Q. et al. Endothelial cell as target for antiphospholipid antibodies. Arthr. and Rheum. 1997; 40: 551-561.
  18. Vora S. K., Asherson R. A., Erkan D. Catastrophic antiphospholipid syndrome. J. Int. Care Med. 2006; 2l: 144-159.
  19. Von Tempelhoff G. E., Heilmann L., Spanuth E. et al. Incidence of the factor V Leiden-mutation, coagulation inhibitor deficiency, and elevated antiphospholipid-antibodies in patients with preeclampsia or HELLP-syndrome. Hemolysis, elevated liver-enzymes, low platelets. Thromb. Res. 2000; 100(4): 363-365.
  20. Макацария А. Д., Бицадзе В. О., Акиньшина С. В. Тромбозы и тромбоэмболии в акушерско-гинекологической клинике. Молекулярно-генетические механизмы и стратегия профилактики тромбоэмболических осложнений: Руководство для врачей. М.: МИА; 2007.

Copyright (c) 2010 Dzhumabaeva B.T., Biryukova L.S., Tsvetaeva N.V., Sukhanova G.A., Vasil'ev S.A., Shavlokhov V.S., Karagyulyan S.R., Kaplanskaya I.B., Petrova V.I., Avdonin P.V., Dzhumabayeva B.T., Biryukova L.S., Tsvetayeva N.V., Sukhanova G.A., Vasilyev S.A., Shavlokhov V.S., Karagyulyan S.R., Kaplanskaya I.B., Petrova V.I., Avdonin P.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

© 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies