Browse > Article
http://dx.doi.org/10.3345/kjp.2010.53.2.253

A case of atypical hemolytic uremic syndrome as an early manifestation of acute lymphoblastic leukemia  

Han, Dong Kyun (Departments of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Baek, Hee Jo (Departments of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Cho, Young Kuk (Departments of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Kim, Chan Jong (Departments of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Shin, Myung Geun (Laboratory Medicine, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Kook, Hoon (Departments of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Hwang, Tai Ju (Departments of Pediatrics, Chonnam National University Hwasun Hospital Chonnam National University Medical School)
Publication Information
Clinical and Experimental Pediatrics / v.53, no.2, 2010 , pp. 253-257 More about this Journal
Abstract
Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in children younger than 4 years and is characterized by microangiopathic hemolytic anemia, acute renal failure, and thrombocytopenia. HUS associated with diarrheal prodrome is usually caused by Shiga toxin-producing Escherichia coli O157:H7 or by Shigella dysenteriae, which generally has a better outcome. However, atypical cases show a tendency to relapse with a poorer prognosis. HUS has been reported to be associated with acute lymphoblastic leukemia (ALL) in children. The characteristics and the mechanisms underlying this condition are largely unknown. In this study, we describe the case of an 11-year-old boy in whom the diagnosis of ALL was preceded by the diagnosis of atypical HUS. Thus, patients with atypical HUS should be diagnosed for the possibility of developing ALL.
Keywords
Hemolytic uremic syndrome; Acute lymphoblastic leukemia; Acute renal failure;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Neild GH. Haemolytic uremic syndrome in practice. Lancet 1994;343:398-401   DOI   ScienceOn
2 Hahn H, Ha IS, Choi HS, Shin HY, Cheong HI, Ahn HS, et al. Acute leukemia: an association with atypical hemolytic uremic syndrome. Pediatr Nephrol 2003;18:703-5   PUBMED   ScienceOn
3 Seigler RL. Spectrum of extrarenal involvement in postdiarrheal hemolytic uremic syndrome. J Pediatr 1994;125:511-8   DOI   PUBMED   ScienceOn
4 Andreoli SP, Bergstein JM. Development of insulin-dependent diabetes mellitus during the hemolytic uremic syndrome. J Pediatr 1982;100:541-5   DOI   PUBMED
5 Bale AF, Brasher C, Seigler RL. CNS manifestations of the hemolytic uremic syndrome. Arch Dis Child 1980;134:869-72
6 Lopez EL, Contrini MM, Devoto S, De Rosa MF, Grana MG, Aversa L, et al. Incomplete hemolytic uremic syndrome in Argentinean children with bloody diarrhea. J Pediatr 1995;127:364-7   DOI   ScienceOn
7 Gasser C, Gautier E, Steck A, Siebenmann RE, Oechslin R. Hemolytic-uremic syndrome: bilateral necrosis of the renal cortex in acute acquired hemolytic anemia. Schweiz Med Wochenschr 1955;85:905-9   PUBMED   ScienceOn
8 Stratta P, Canavese C, Dogliani M, Thea A, Degani G, Mairone L, et al. Hemolytic uremic syndrome during recombinant alpha-interferon treatment for hairy cell leukemia. Ren Fail 1993;15:559-61   DOI   ScienceOn
9 Kaplan B, Levin M, De Chadarevian JP. The hemolytic uremic syndrome. In: Edelman C Jr, editor. Pediatric kidney disease. 2nd ed. Bonston: Little Brown, 1992:1383-1405
10 Fitzpatrick MM, Dillon MJ. Current views on aetiology and management of haemolytic uraemic syndrome. Postgrad Med 1991;67:707-9   DOI   ScienceOn
11 Mitra D, Jaffe EA, Weksler B, Hajjar KA, Soderland C, Laurence J. Thrombotic thrombocytopenic purpura and sporadic hemolytic-uremic syndrome plasmas induce apoptosis in restricted lineages of human microvascular endothelial cells. Blood 1997;89:1224-34   PUBMED   ScienceOn
12 Gordon LI, Kwaan HC. Thrombotic microangiopathy manifesting as thrombotic thrombocytopenic purpura/hemolytic uremic syndrome in the cancer patient. Semin Thromb Hemost 1999;25:217-21   DOI   ScienceOn
13 Karpman D, Andreasson A, Thysell H, Kaplan BS. Serum and urinary cytokines in childhood haemolytic uremic syndrome and thrombotic thrombocytopenic purpura. In: Karmali MA, Goglio AG, editors. Recent advances in verocytotoxin-producing Escherichia coli infection: proceedings of the 2nd International Symposium and Workshop on Verocytotoxin (Shigalike toxin)-producing Escherichia coli Infection. Elsevier, Bergamo, Italy, 1994;369-72
14 Lowe EJ, Werner EJ. Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome in children and adolescents. Semin Thromb Hemost 2005;31:717-30   DOI   ScienceOn
15 Salcedo JR, Fusner J. Hemolytic uremic syndrome followed by acute lymphocytic leukemia. Int J Pediatr Nephrol 1986;7:169-72   PUBMED
16 Kaplan B, Meyers K, Schulman S. The pathogenesis and treatment of hemolytic uremic syndrome. J Am Soc Nephrol 1998;9:1126-33   PUBMED   ScienceOn
17 Quaye IK. Haptoglobin, inflammation and disease. Trans R Soc Trop Med Hyg 2008;102:735-42   DOI   PUBMED   ScienceOn
18 Lopez EL, Contrini MM, De Rosa S. Tumor necrosis factor (TNF-a) levels in hemolytic uremic syndrome (HUS) patients and children with bloody diarrhea (BD) in Argentina. In: Karmali MA, Goglio AG, editors. Recent advances in verocytotoxin-producing Escherichia coli infection: proceedings of the 2nd International Symposium and Workshop on Verocytotoxin (Shiga-like toxin)-producing Escherichia coli Infection. Elsevier, Bergamo, Italy, 1994;373-6
19 Martini G, Dall'Amico R, Murer L, Montini G, D'Avino A, Zacchello G. Hemolytic uremic syndrome as a presenting form of acute lymphocytic leukemia. Ann Hematol 2000;79:452-4   DOI   ScienceOn
20 Krauss S, Sonoda T, Solomon A. Treatment of advanced gastrointestinal cancer with 5-fluorouracil and mitomycin C. Cancer 1979;43:1598-603   DOI   ScienceOn