A 3-year-old girl was admitted with typical hemolytic uremic syndrome (HUS) and conservative treatments were initiated. During hospitalization, she had seizures, right hemiparesis, and loss of consciousness. Initial MR of the brain showed changes of acute disseminated encephalomyelitis (ADEM). She was treated with intravenous methylprednisolone and immunoglobulin. Upon improvement of her clinical condition, she was discharged with oral prednisolone which was tapered after two months. After one year fallow-up, the child now has a normal renal function and normal neurodevelopment.
Johnson S. Mark Taylor C. Hemolytic Uremic Syndrome. In: Ellis D. Avner, William E. Harmon, Patrick Niaudet. Pediatric Nephrology. 2009. 6th Edition. P. 1155-1167.
Waters AM, Kerecuk L, Luk D, et al. Hemolytic uremic syndrome associated with invasive pneumococcal disease. J Pediatr 2007;151 (2):140–144.
Nathan P. Young, D.O. Brian G. et al. Acute Disseminated Encephalomyelitis: Current Understanding and Controversies. Semin Neurol. 2008;28(1):84-94. (Homepage at www.thieme.com)
Hynson JL, Kornberg AJ, Coleman LT, et al: Clinical and radiological features of acute disseminated encephalo- myelitis in children, Neurology 2001;56:1308–1312.
Khurana DR, Melvin JM, Kothare SV, et al: Acute dissemi- nated encephalomyelitis in children: discordant neuro- logic and neuroimaging abnormalities and response to plasmapheresis. Pediatrics 2005;116:431–436.
National Institute of Neurological Disorders and Stroke. Acute Disseminated Encephalomyelitis. www.ninds.nih.gov/ Accessed 11/22/2011