Case series: coronavirus disease 2019 infection as a precipitant of atypical hemolytic uremic syndrome: two case reports

Atypical hemolytic uremic syndrome is an exceedingly rare thrombotic microangiopathy caused by accelerated activation of the alternative complement pathway. Here, we report two cases of patients presenting with suspected atypical hemolytic uremic syndrome precipitated by coronavirus disease 2019 inf...

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Bibliographic Details
Published in:Journal of medical case reports 2021-12, Vol.15 (1), p.587-587, Article 587
Main Authors: Kurian, Christine J, French, Zachary, Kukulich, Patrick, Lankiewicz, Matthew, Ghimire, Sushil, Maarouf, Omar H, Rizk, Sanaa, Rhoades, Ruben
Format: Article
Language:English
Subjects:
Adult
Anemia
Antibiotics
Atypical hemolytic uremic syndrome
Atypical Hemolytic Uremic Syndrome - diagnosis
Atypical Hemolytic Uremic Syndrome - drug therapy
Case Report
Case reports
Coronaviruses
COVID-19
COVID-19 diagnostic tests
COVID-19 vaccines
Creatinine
Disease prevention
Family medical history
Female
Hepatitis
Hospitalization
Humans
Infections
Influenza
Kidneys
Male
Mutation
Nausea
Nonimmune hemolytic anemia
Patients
Purpura, Thrombotic Thrombocytopenic
SARS-CoV-2
Steroids
Thrombocytopenia
Thrombotic Microangiopathies
Thrombotic microangiopathy
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Summary:Atypical hemolytic uremic syndrome is an exceedingly rare thrombotic microangiopathy caused by accelerated activation of the alternative complement pathway. Here, we report two cases of patients presenting with suspected atypical hemolytic uremic syndrome precipitated by coronavirus disease 2019 infection. The first patient, a 25-year-old Hispanic male, had one prior episode of thrombotic microangiopathy presumed to be atypical hemolytic uremic syndrome precipitated by influenza A, and re-presented with thrombocytopenia, microangiopathic hemolytic anemia, nonoliguric renal failure, and normal ADAMTS13 activity, with confirmed coronavirus disease 2019 positivity. The second patient, a 31-year-old Caucasian female, had no personal history of thrombotic microangiopathy, though reported a family history of suspected atypical hemolytic uremic syndrome. She presented with similar laboratory derangements, oliguric renal failure requiring hemodialysis, and confirmed coronavirus disease 2019 positivity. Both patients were treated with eculizumab with complete resolution of their hematologic and renal complications. To our knowledge, this represents the largest case series of atypical hemolytic uremic syndrome precipitated by coronavirus disease 2019 in adults.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-021-03144-2