Chinchilla-López P, Cruz-Ramón V, Ramírez-Pérez O, Méndez-Sánchez N. Gastroenteritis in an adult female revealing hemolytic uremic syndrome: Case report. World J Gastroenterol 2018; 24(6): 763-766 [PMID: 29456415 DOI: 10.3748/wjg.v24.i6.763]
Corresponding Author of This Article
Nahum Méndez-Sánchez, MD, MSc, PhD, Professor, Liver Research Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Col. Toriello Guerra, México City 14050, México. nmendez@medicasur.org.mx
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Chinchilla-López P, Cruz-Ramón V, Ramírez-Pérez O, Méndez-Sánchez N. Gastroenteritis in an adult female revealing hemolytic uremic syndrome: Case report. World J Gastroenterol 2018; 24(6): 763-766 [PMID: 29456415 DOI: 10.3748/wjg.v24.i6.763]
World J Gastroenterol. Feb 14, 2018; 24(6): 763-766 Published online Feb 14, 2018. doi: 10.3748/wjg.v24.i6.763
Gastroenteritis in an adult female revealing hemolytic uremic syndrome: Case report
Paulina Chinchilla-López, Vania Cruz-Ramón, Oscar Ramírez-Pérez, Nahum Méndez-Sánchez
Paulina Chinchilla-López, Vania Cruz-Ramón, Oscar Ramírez-Pérez, Nahum Méndez-Sánchez, Liver Research Unit, Medica Sur Clinic and Foundation, Mexico City 14050, Mexico
Author contributions: Chinchilla-Lopez P, Cruz-Ramón V and Ramirez-Pérez O analyzed the data and wrote the paper; Méndez-Sánchez N designed the report, diagnostic approach to patient with suspected gastroenteritis associated with hemolytic uremic Syndrome.
Informed consent statement: The patient involved in this study gave her written informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: All authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nahum Méndez-Sánchez, MD, MSc, PhD, Professor, Liver Research Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Col. Toriello Guerra, México City 14050, México. nmendez@medicasur.org.mx
Received: November 16, 2017 Peer-review started: November 17, 2017 First decision: December 13, 2017 Revised: December 15, 2017 Accepted: December 20, 2017 Article in press: December 20, 2017 Published online: February 14, 2018 Processing time: 81 Days and 4.2 Hours
ARTICLE HIGHLIGHTS
Case characteristics
A 61-year-old woman, with hypertension, osteoarthritis and irritable bowel syndrome, presented to emergency department after 5 d of bloody diarrhea without mucus.
Clinical diagnosis
The diagnosis of hemolytic uremic syndrome (HUS) was based on the presence of diarrheal prodrome, thrombocytopenia and the development of acute renal failure.
Differential diagnosis
Thrombotic thrombocytic purpura and other causes of thrombocytopenia.
Laboratory diagnosis
Moderate hydroelectrolytic disequilibrium, thrombocytopenia and microangiopathic hemolytic anemia.
Pathological diagnosis
The culture showed the presence of E. coli producing extended-spectrum β-lactamases.
Treatment
Fluid and electrolyte replacement, plasma exchange, hemodialysis and intravenous antibiotic therapy with ertapenem.
Related reports
HUS associated to gastroenteritis is a rare event in adults due to very few cases had been detected. However, this disorder has high mortality but good prognosis when it is diagnosed in early stages. The treatment should be based on syndromic approach according to guidelines.
Term explanation
ADAMTS13 - a disintegrin-like metalloproteinase with thrombospondin motif type 1 member 13 - cleaves Von Willebrand factor anchored on the endothelial surface, in circulation, and at the sites of vascular injury.
Experiences and lessons
The gastroenterologist may encounter the HUS as it presents with primarily intestinal symptoms or may assist in the management of the abdominal complications. Anticipation of the broad clinical scope of the HUS is essential for the optimal management of this serious entity.
