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Spontaneous Recovery Of The Hemolytic Uremic Syndrome With Prolonged Renal And Neurological Manifestations

Kahn et al., 1982Other/Unknown

Nephron 32: 1982; 188-191

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Abstract

A three-year-old girl who had for two months suffered bruising after minimal injury was admitted because of diffuse ecchymoses and a large haematoma hindering elbow movement. These symptoms were attributable to the development of antifactor VIII inhibitor. No definite etiology was evident despite repeated immunological investigation. Although the inhibitor still persisted at high levels after two years, no further haemorrhage occurred, excepted haematomas three months after the onset of symptoms, in association with mumps.

Case Details

Personal Characteristics

3-year-old girl

Clinical Characteristics

Severe hemolytic-uremic syndrome with oligoanuric for 31 days and coma for 35 days associated with cortical blindness

Remission Characteristics

Recovered both neurologic and renal function

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Peritoneal dialysis and supportive care only

Additional Notes

The spontaneous recovery of this patient, who had a particularly severe form of the hemolytic uremic syndrome, brings into question the necessity for the use of anticoagulation, antiplatelet agents, prostacyclin, and plasma exchange as treatments for the hemolytic-uremic syndrome.