Difficulties in diagnosis and treatment of atypical hemolytic-uremic syndrome: a clinical case


DOI: https://dx.doi.org/10.18565/nephrology.2024.2.58-60

Bakhareva Y.S., Chapaeva N.N.

1) Research Institute of Therapy and Preventive Medicine – Branch Campus of the Federal Research Center Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia; 2) Novosibirsk State Medical University of the Ministry of Health of the Russian Federation, Novosibirsk, Russia
Background. Atypical hemolytic uremic syndrome (aHUS) is a disease with uncontrolled activation of the alternative complement pathway leading to the development of complement-mediated thrombotic microangiopathy (TMA). A typical triad of aHUS includes acute kidney injury (AKI), nonimmune hemolytic anemia, and consumptive thrombocytopenia.
Objective. Demonstration of the difficulties of diagnosing and treating aHUS.
Clinical case. Patient D., 19 years old, AKI sharply developed after a viral infection. Symptoms characteristic of aHUS included anemia, thrombocytopenia and AKI. Discussion of the diagnosis of TMA within the framework of aHUS became possible due to the results of the patient’s examination for ADAMTS-13, complete restoration of renal function during plasma therapy.
Conclusion. It is extremely important for doctors to be aware of the possibilities of timely diagnosis of aHUS; adequate pathogenetic therapy provides complete restoration of the function of the affected organs.
Keywords: hemolytic anemia, atypical hemolytic-uremic syndrome, thrombocytopenia, thrombotic microangiopathy, acute kidney injury
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About the Autors

Yulia S. Bakhareva – Junior Researcher, Laboratory of Clinical, Population and Preventive Research of Therapeutic and Endocrine Diseases, Research Institute of Therapy and Preventive Medicine – Branch Campus of the Federal Research Center Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences.
Address: 175/1 B.Bogatkov st., Novosibirsk, 630089; tel.: +7 (953) 857-85-11, 8578511; e-mail: 8578511@inbox.ru. ORCID: https://orcid.org/0000-0003-0480-1510.
Natalya N. Chapaeva – Dr.Sci. (Med.), Professor at the Department of Hospital Therapy, Novosibirsk State Medical University. Address: 52 Krasny prospect, Novosibirsk, 630091; tel.: +7 (913) 912-23-45; e-mail: n.chapaeva@mail.ru. ORCID: https://orcid.org/0000-0003-0907-5044.


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