Hemolytic Uremic Syndrome Caused by Mycoplasma Pneumoniae Infection in Children: A Case Report and Literature Review
DOI:
https://doi.org/10.31584/jhsmr.2021848Keywords:
end-stage renal disease, hemolytic uremic syndrome, mycoplasma pneumoniae, thrombotic microangiopathyAbstract
We describe the case of a 6-year-old boy with a Mycoplasma pneumoniae (M. pneumoniae) respiratory tract infection associated with thrombotic microangiopathic hemolytic anemia and thrombocytopenia with renal failure which was diagnosed as atypical hemolytic uremic syndrome. Renal biopsy showed features of thrombotic microangiopathy. The patient was treated with azithromycin for the M. pneumoniae infection, and supportive care with red cell transfusion and renal dialysis in the acute period. The microangiopathic hemolytic anemia and thrombocytopenia resolved within 2 months after diagnosis but the renal function damage was irreversible. The patient developed end-stage renal disease and required long term renal replacement therapy.
References
Fakhouri F, Zuber J, Fr meaux-Bacchi V, Loirat C. Haemolytic uraemic syndrome. Lancet 2017;390:681-96.
Lynn RM, O’Brien SJ, Taylor CM, Adak GK, Chart H, Cheasty T, et al. Childhood hemolytic uremic syndrome, United Kingdom and Ireland. Emerg Infect Dis 2005;11:590-6.
Espi E, Grimont F, Mariani-Kurkdjian P, Bouvet P, Haeghebaert S, Filliol I, et al. Surveillance of hemolytic uremic syndrome in children less than 15 years of age, a system to monitor O157 and non-O157 Shiga toxin-producing Escherichia coli infections in France, 1996-2006. Pediatr Infect Dis J 2008;27:595-601.
Schifferli A, von Vigier RO, Fontana M, Spart G, Schmid H, Bianchetti MG, et al. Hemolytic-uremic syndrome in Switzerland: a nationwide surveillance 1997-2003. Eur J Pediatr 2010;169: 591-8.
Narita M. Classification of extrapulmonary manifestations due to Mycoplasma pneumoniae infection on the basis of possible pathogenesis. Front Microbiol 2016;7:23.
Ariceta G, Besbas N, Johnson S, Karpman D, Landau D, Licht C, et al. Guideline for the investigation and initial therapy of diarrhea-negative hemolytic uremic syndrome. Pediatr Nephrol 2009;24:687-96.
Bugajer-Gleitman HE, Balzar E, Lubec G, May L, Weissenbacher G. The presence of cold agglutinins in hemolytic uremic syndrome. Padiatr Padol 1976;11:245-53.
Fitzpatrick MM, Walters MD, Trompeter RS, Dillon MJ, Barratt TM. Atypical (non-diarrhea-associated) hemolytic-uremic syndrome in childhood. J Pediatr 1993;122:532-7.
Godron A, Pereyre S, Monet C, Llanas B, Harambat J. Hemolytic uremic syndrome complicating Mycoplasma pneumoniae infection. Pediatr Nephrol 2013;28:2057-60.
Miklaszewska M, Zachwieja K, Drożdż D, Pallinger E, Takacs B, Szilagyi A, et al. Hemolytic uremic syndrome with Mycoplasma pneumoniae infection and membrane cofactor protein mutation - case report. Przegl Lek 2016;73:862-4.
Carrara C, Abbate M, Sabadini E, Remuzzi G. Acute kidney injury and hemolytic anemia secondary to Mycoplasma pneumoniae infection. Nephron 2017;137:148-54.
Kakajiwala A, Bhatti T, Kaplan BS, Ruebner RL, Copelovitch L. Post-streptococcal glomerulonephritis associated with atypical hemolytic uremic syndrome: to treat or not to treat with eculizumab? Clin Kidney J 2016;9:90-6.
Noris M, Caprioli J, Bresin E, Mossali C, Pianetti G, Gamba S, et al. Relative role of genetic complement abnormalities in sporadic and familial aHUS and their impact on clinical phenotype. Clin J Am Soc Nephrol 2010;5:1844-59.
Fremeaux-Bacchi V, Fakhouri F, Garnier A, Bienaim F, Dragon-Durey MA, Ngo S, et al. Genetics and outcome of atypical hemolytic uremic syndrome: a nationwide French series comparing children and adults. Clin J Am Soc Nephrol 2013;8:554-62.
Adra AL, Vigue MG, Dalla Vale F, Ichay L, Raynaud P, Mariani A, et al. Favorable outcome in a case of Mycoplasma pneumoniae-associated crescentic glomerulonephritis. Pediatr Nephrol 2010;25:1765-9.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
