Wang XL, Du Y, Zhao CG, Wu YB, Yang N, Pei L, Wang LJ, Wang QS. Streptococcal pneumonia-associated hemolytic uremic syndrome treated by T-antibody-negative plasma exchange in children: Two case reports. World J Clin Cases 2021; 9(27): 8164-8170 [PMID: 34621876 DOI: 10.12998/wjcc.v9.i27.8164]
Corresponding Author of This Article
Yue Du, MD, Chief Doctor, Department of Pediatrics, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. duy@sj-hospital.org
Research Domain of This Article
Pediatrics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
World J Clin Cases. Sep 26, 2021; 9(27): 8164-8170 Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8164
Streptococcal pneumonia-associated hemolytic uremic syndrome treated by T-antibody-negative plasma exchange in children: Two case reports
Xiu-Li Wang, Yue Du, Cheng-Guang Zhao, Yu-Bin Wu, Ni Yang, Liang Pei, Li-Jie Wang, Qiu-Shi Wang
Xiu-Li Wang, Yue Du, Cheng-Guang Zhao, Yu-Bin Wu, Ni Yang, Liang Pei, Li-Jie Wang, Qiu-Shi Wang, Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Qiu-Shi Wang, Department of Blood Transfusion, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Du Y and Wang QS designed the new treatment; Wang XL and Zhao CG analyzed the data and co-wrote the manuscript; Wu YB, Yang N, Pei L and Wang LJ cared for the patient; All authors read and approved the final manuscript.
Informed consent statement: Written consents were obtained from the parents of the patients for publication.
Conflict-of-interest statement: No financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Yue Du, MD, Chief Doctor, Department of Pediatrics, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. duy@sj-hospital.org
Received: April 26, 2021 Peer-review started: April 26, 2021 First decision: May 24, 2021 Revised: May 29, 2021 Accepted: July 28, 2021 Article in press: July 28, 2021 Published online: September 26, 2021 Processing time: 143 Days and 7.7 Hours
Abstract
BACKGROUND
The occurrence of Streptococcus pneumoniae-associated hemolytic uremic syndrome (SP-HUS) is increasing. Thomsen-Friedenreich antigen activation is highly involved in the pathogenesis of SP-HUS, and T-antibody-negative plasma exchange (PE) may be effective in the treatment of severe cases of SP-HUS.
CASE SUMMARY
We retrospectively reviewed two pediatric patients with SP-HUS. Both clinical features and laboratory examination results of the children were described. T-antibody-negative PE was performed in both cases. Both children made a full recovery after repeated PE and remained well at a 2 year follow-up.
CONCLUSION
Streptococcal pneumonia continues to be an uncommon but important cause of HUS. The successful treatment of the presented cases suggests that T-antibody-negative PE may benefit patients with SP-HUS.
Core Tip: We present the cases of two pediatric patients with atypical hemolytic uremic syndrome associated with Streptococcus pneumoniae-hemolytic uremic syndrome that was successfully treated by T-antibody-negative plasma exchange. The patients were followed up for 2 years with normalization of all laboratory parameters, normal blood pressure and normal renal function.
