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  • Title: Renal transplantation after Streptococcus pneumoniae-associated hemolytic uremic syndrome.
    Author: Krysan DJ, Flynn JT.
    Journal: Am J Kidney Dis; 2001 Feb; 37(2):E15. PubMed ID: 11157401.
    Abstract:
    Of the several causes of nondiarrheal hemolytic uremic syndrome (HUS), infection with Streptococcus pneumoniae is infrequent, but important, because of its unique pathogenesis. A comprehensive literature review found 37 well-documented cases of S pneumoniae-associated HUS (SP-HUS), only 2 of which progressed to end-stage renal disease (ESRD). We report the third such child, and the first to receive a renal transplant following SP-HUS. Her course illustrates several unique characteristics of SP-HUS common to previous patients reported in the literature, including a greater duration of oligoanuria compared with cases not progressing to ESRD, the significant adverse effect of unwashed blood products, and a possible influence of female gender on outcome. Clinicians caring for children with SP-HUS should be aware of these differences and modify therapy appropriately to avoid known risk factors for poor outcome, specifically the use of unwashed blood products.
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