Dilated Cardiomyopathy Several Months after Hemolytic Uremic Syndrome
Journal of Pediatric Nephrology,
Vol. 4 No. 1 (2016),
13 February 2016
,
Page 45-48
https://doi.org/10.22037/jpn.v4i1.11094
Abstract
This is a report of a 44-month-old baby girl diagnosed as a case of atypical hemolytic uremic syndrome (aHUS) presenting with hematuria, periorbital edema, anemia, thrombocytopenia, and hypertension lacking any history of previous bloody diarrhea. She was treated with plasma infusion followed by plasmapheresis and peritoneal dialysis. After two months, she was discharged in remission undergoing periodic plasmapheresis. Four months later, she was visited for fatigue, tachypnea, and palpitation. Cardiac evaluation revealed dilated cardiomyopathy with an ejection fraction of 15-20%. She was hospitalized and treated with inotropes and diuretics; one week later, she was discharged in a favorable condition. After six months follow-up, she showed an acceptable renal and cardiac state. It seems that cardiomyopathy can occur as a late and rare complication of HUS. We recommend cardiac evaluation for all patients with HUS at its presentation and in later follow-ups.
Keywords: Cardiomyopathy; Hemolytic Uremic Syndrome; Child.How to Cite
References
Kavanagh D, Goodship TH, Richards A. Atypical hemolytic uremic syndrome. Semin Nephrol 2013;33(6):508-530.
Fremeaux-Bacchi V, Fakhouri F, Garnier A, 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(4):554-562.
Nester CM, Thomas CP. Atypical hemolytic uremic syndrome: what is it, how is it diagnosed, and how is it treated? Hematology Am Soc Hematol Educ Program. 2012;2012:617-625.
Noris M, Caprioli J, Bresin E, 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(10):1844-1859.
Maga TK, Nishimura CJ, Weaver AE, Frees KL, Smith RJ. Mutations in alternative pathway complement proteins in American patients with atypical hemolytic uremic syndrome. Hum Mutat. Jun 2010;31(6):E1445-1460.
Loirat C, Fakhouri F, Ariceta G, et al. An international consensus approach to the management of atypical hemolytic uremic syndrome in children. Pediatr Nephrol 2016;31(1):15-39.
Ariceta G, Besbas N, Johnson S, et al. Guideline for the investigation and initial therapy of diarrhea-negative hemolytic uremic syndrome. Pediatr Nephrol 2009;24(4):687-696.
Eckart P, Guillot M, Jokic M, et al. [Cardiac involvement during classic hemolytic uremic syndrome]. Arch Pediatr 1999;6(4):430-433.
Abu-Arafeh I, Gray E, Youngson G, Auchterlonie I, Russell G. Myocarditis and haemolytic uraemic syndrome. Arch Dis Child 1995;72(1):46-47.
Webb JG, Butany J, Langer G, Scott G, Liu PP. Myocarditis and myocardial hemorrhage associated with thrombotic thrombocytopenic purpura. Arch Intern Med 1990;150(7):1535-1537.
Thomas NJ, Messina JJ, DeBruin WJ, Carcillo JA. Cardiac failure in hemolytic uremic syndrome and rescue with extracorporeal life support. Pediatr Cardiol 2005;26(1):104-106.
Walker AM, Benson LN, Wilson GJ, Arbus GS. Cardiomyopathy: a late complication of hemolytic uremic syndrome. Pediatr Nephrol 1997;11(2):221-222.
Poulton J, Taylor CM, De Giovanni JV. Dilated cardiomyopathy associated with haemolytic uraemic syndrome. Br Heart J 1987;57(2):181-183.
Taylor CM, White RH, Winterborn MH, Rowe B. Haemolytic-uraemic syndrome: clinical experience of an outbreak in the West Midlands. Br Med J (Clin Res Ed) 1986;292(6534):1513-1516.
Cosmai EM, Puzis L, Tsai HM, Lian EC. Thrombocytopenic purpura and cardiomyopathy in pregnancy reversed by combined plasma exchange and infusion. Eur J Haematol 2002;68(4):239-242.
Alexopoulou A, Dourakis SP, Zovoilis C, et al. Dilated cardiomyopathy during the course of hemolytic uremic syndrome. Int J Hematol 2007;86(4):333-336.
Leray H, Mourad G, du Cailar G, Mion C. [Dilated cardiomyopathy during post-partum hemolytic and uremic syndrome (HUS)]. Nephrologie. 1991;12(5):237-240.
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