Secondary hemolytic-uremic syndrome
From IDWiki
Background
- One of the thrombotic microangiopathies
- Different pathophysiology and treatment from typical hemolytic-uremic syndrome (after STEC diarrhea) and atypical hemolytic-uremic syndrome (though often grouped with aHUS)
- Associated with autoimmune diseases, transplantation, malignancy, infection, cytotoxic mediation, or pregnancy
- Most common associations are with Streptococcus pneumoniae and influenza
- Possibly acute Clostridioides difficile[1][2][3]
- Solid organ transplantation, mostly in the month or months after transplantation but rarely after a year[4]
- Hematopoietic stem cell transplantation, up to months to years after transplant
- Systemic lupus erythematosus[5]
- Multiple solid organ malignancies (usually metastatic) are associated with TMA, though prostate cancer (non-metastatic) appears to favour an HUS-like pattern[6]
- Normal pregnancy[7]
- Drug-induced thrombotic microangiopathy
- ↑ Keshtkar-Jahromi M, Mohebtash M. Hemolytic uremic syndrome and Clostridium difficile colitis. J Community Hosp Intern Med Perspect. 2012 Oct 15;2(3). doi: 10.3402/jchimp.v2i3.19064. PMID: 23882375; PMCID: PMC3714067.
- ↑ Khurshid Q, Mahmoud A, Shahid M, Mohamed A, Shahbaz A. Atypical Hemolytic Uremic Syndrome Associated With Clostridium Difficile Infection. Cureus. 2020 Jul 5;12(7):e9005. doi: 10.7759/cureus.9005. PMID: 32775085; PMCID: PMC7402547.
- ↑ Alvarado AS, Brodsky SV, Nadasdy T, Singh N. Hemolytic uremic syndrome associated with Clostridium difficile infection. Clin Nephrol. 2014 Apr;81(4):302-6. doi: 10.5414/CN107691. PMID: 23320969.
- ↑ Caires RA, Marques ID, Repizo LP, Sato VA, Carmo LP, Machado DJ, de Paula FJ, Nahas WC, David-Neto E. De novo thrombotic microangiopathy after kidney transplantation: clinical features, treatment, and long-term patient and graft survival. Transplant Proc. 2012 Oct;44(8):2388-90. doi: 10.1016/j.transproceed.2012.07.039. PMID: 23026601.
- ↑ Hughson MD, Nadasdy T, McCarty GA, Sholer C, Min KW, Silva F. Renal thrombotic microangiopathy in patients with systemic lupus erythematosus and the antiphospholipid syndrome. Am J Kidney Dis. 1992 Aug;20(2):150-8. doi: 10.1016/s0272-6386(12)80543-9. PMID: 1496968.
- ↑ Lechner K, Obermeier HL. Cancer-related microangiopathic hemolytic anemia: clinical and laboratory features in 168 reported cases. Medicine (Baltimore). 2012 Jul;91(4):195-205. doi: 10.1097/MD.0b013e3182603598. PMID: 22732949.
- ↑ Egbor M, Johnson A, Harris F, Makanjoula D, Shehata H. Pregnancy-associated atypical haemolytic uraemic syndrome in the postpartum period: a case report and review of the literature. Obstet Med. 2011 Jun;4(2):83-5. doi: 10.1258/om.2011.100059. Epub 2011 Jun 9. PMID: 27582861; PMCID: PMC4989735.
