CASE REPORTS   

Gazzetta Medica Italiana-Archivio per le Scienze Mediche 2009 June;168(3):203-6

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: Italian

Nephrotic syndrome as consequence of hemolytic uremic sindrome

Colombo M., Vettore E., Volpini S., Fazi M. C., Tedoldi S., Pedroni F.

Servizio di Microbiologia Unità Operativa di Pediatria Presidio Ospedaliero di Manerbio, Brescia, Italia

Hemolitic-uremic syndrome is an infrequent but not rare desease in Pediatrics, expecially in children from two to four years of age. It is often preceded by an acute gastrointestinal infection (Escherichia coli O157: H7 is the pathogenic agent more frequently implicated). We present the case of a 2-year-old child who came to our first aid department after one week of pallor and asthenia. Some days before he had an acute gastrointestinal infection. We immediately took blood tests and the results were: haemoglobin 6.7 g/dL, platelets 214 000 mm3, azotemia 104 mg/dL, creatine 1.1 mg/dL. Relying upon the clinical picture and the blood tests we diagnosed hemolitic-uremic syndrome and we decided to hospitalize the patient. After ten days there was a spontaneous rise in the values of haemoglobin and the normalization of azotemia; there was the persistence of renal disorder compatible with nephrotic syndrome. The literature report on many cases of patients with renal disorders (glomerural disease, nephrotic syndrome) who develop hemolitic-uremic syndrome. On the contrary, in our patient we could suppose the nephrotic syndrome is an event coming out after the hemolitic-uremic syndrome and this is rarely described in literature. The association between those two renal pathologies (hemolitic-uremic syndrome and nephrotic syndrome) could be the object of discussion an in-depth study.