Skip to main content
Top
Published in: BMC Nephrology 1/2014

Open Access 01-12-2014 | Case report

Alcohol-induced severe acute pancreatitis followed by hemolytic uremic syndrome managed with continuous renal replacement therapy

Authors: Peng Fu, Ai-hong Yuan, Chun-hua Wang, Xin Li, Hai-yang Wu

Published in: BMC Nephrology | Issue 1/2014

Login to get access

Abstract

Background

Acute kidney injury in patients with acute pancreatitis carries a poor prognosis. Hemolytic uremic syndrome (HUS) is characterized by non-immune hemolytic anemia, thrombocytopenia, and renal failure caused by platelet thrombi in the microcirculation of the kidney, and though rare in adults it is associated with high mortality and a high rate of chronic renal failure.

Case presentation

Herein, we report a case of alcohol-induced acute pancreatitis in a 38-year-old Chinese female complicated by HUS. Her renal function progressively deteriorated in 2 days, and daily continuous renal replacement therapy (CRRT) was thus performed for a total of 13 treatments. She also received intermittent transfusions of fresh frozen plasma. Her renal failure was successfully managed, with subsequent return of normal renal function. She was discharged 1 month after admission and follow-up at 3 months revealed normal urea and creatinine.

Conclusion

CRRT was shown to be useful for the treatment of HUS following acute pancreatitis. Prior case reports and our case should remind clinicians that HUS is a possible complication of acute pancreatitis. This study highlights the importance of early diagnosis and prompt initiation of CRRT to prevent mortality and improve outcomes.
Literature
1.
go back to reference Swisher KK, Doan JT, Vesely SK, Kwaan HC, Kim B, Lämmle B, Kremer Hovinga JA, George JN: Pancreatitis preceding acute episodes of thrombotic thrombocytopenic purpura-hemalytic uremic syndrome: report of five patients with a systematic review of published reports. Haematologica. 2007, 92 (7): 936-943. 10.3324/haematol.10963.CrossRefPubMed Swisher KK, Doan JT, Vesely SK, Kwaan HC, Kim B, Lämmle B, Kremer Hovinga JA, George JN: Pancreatitis preceding acute episodes of thrombotic thrombocytopenic purpura-hemalytic uremic syndrome: report of five patients with a systematic review of published reports. Haematologica. 2007, 92 (7): 936-943. 10.3324/haematol.10963.CrossRefPubMed
2.
go back to reference Tostivint I, Mougenot B, Flahault A, Vigneau C, Costa MA, Haymann JP, Sraer JD, Rondeau E: Adult haemolytic and uraemic syndrome: causes and prognostic factors in the last decade. Nephrol Dial Transplant. 2002, 17 (7): 1228-1234. 10.1093/ndt/17.7.1228.CrossRefPubMed Tostivint I, Mougenot B, Flahault A, Vigneau C, Costa MA, Haymann JP, Sraer JD, Rondeau E: Adult haemolytic and uraemic syndrome: causes and prognostic factors in the last decade. Nephrol Dial Transplant. 2002, 17 (7): 1228-1234. 10.1093/ndt/17.7.1228.CrossRefPubMed
3.
4.
go back to reference Silva VA: Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome secondary to pancreatitis. Am J Hematol. 1995, 50 (1): 53-56. 10.1002/ajh.2830500111.CrossRefPubMed Silva VA: Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome secondary to pancreatitis. Am J Hematol. 1995, 50 (1): 53-56. 10.1002/ajh.2830500111.CrossRefPubMed
5.
go back to reference Daryanani S, Wilde JT: Relapsing thrombotic thrombocytopenic purpura in association with recurrent pancreatitis. Clin Lab Haematol. 1998, 20 (5): 317-318. 10.1046/j.1365-2257.1998.00140.x.CrossRefPubMed Daryanani S, Wilde JT: Relapsing thrombotic thrombocytopenic purpura in association with recurrent pancreatitis. Clin Lab Haematol. 1998, 20 (5): 317-318. 10.1046/j.1365-2257.1998.00140.x.CrossRefPubMed
6.
go back to reference Bernardo A, Ball C, Nolasco L, Moake J, Dong JF: Effects of inflammatory cytokines on the release and cleavage of the endothelial cell-derived ultra-large von Willebrand factor multimers under flow. Blood. 2004, 104 (1): 100-106. 10.1182/blood-2004-01-0107.CrossRefPubMed Bernardo A, Ball C, Nolasco L, Moake J, Dong JF: Effects of inflammatory cytokines on the release and cleavage of the endothelial cell-derived ultra-large von Willebrand factor multimers under flow. Blood. 2004, 104 (1): 100-106. 10.1182/blood-2004-01-0107.CrossRefPubMed
7.
go back to reference Chang JC, Kathula SK: Various clinical manifestations in patients with thrombotic microangiopathy. J Investig Med. 2002, 50 (3): 201-206. 10.2310/6650.2002.33434.CrossRefPubMed Chang JC, Kathula SK: Various clinical manifestations in patients with thrombotic microangiopathy. J Investig Med. 2002, 50 (3): 201-206. 10.2310/6650.2002.33434.CrossRefPubMed
8.
go back to reference Gourley BL, Mesa H, Gupta P: Rapid and complete resolution of chemotherapy-induced thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) with rituximab. Cancer Chemother Pharmacol. 2010, 65 (5): 1001-1004. 10.1007/s00280-010-1258-4.CrossRefPubMed Gourley BL, Mesa H, Gupta P: Rapid and complete resolution of chemotherapy-induced thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS) with rituximab. Cancer Chemother Pharmacol. 2010, 65 (5): 1001-1004. 10.1007/s00280-010-1258-4.CrossRefPubMed
9.
go back to reference Caramazza D, Quintini G, Abbene I, Malato A, Saccullo G, Lo Coco L, Di Trapani R, Palazzolo R, Barone R, Mazzola G, Rizzo S, Ragonese P, Aridon P, Abbadessa V, Siragusa S: Relapsing or refractory idiopathic thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: the role of rituximab. Transfusion. 2010, 50 (12): 2753-2760. 10.1111/j.1537-2995.2010.02763.x.CrossRefPubMed Caramazza D, Quintini G, Abbene I, Malato A, Saccullo G, Lo Coco L, Di Trapani R, Palazzolo R, Barone R, Mazzola G, Rizzo S, Ragonese P, Aridon P, Abbadessa V, Siragusa S: Relapsing or refractory idiopathic thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: the role of rituximab. Transfusion. 2010, 50 (12): 2753-2760. 10.1111/j.1537-2995.2010.02763.x.CrossRefPubMed
10.
go back to reference Prowle JR, Bellomo R: Continuous renal replacement therapy: recent advances and future research. Nat Rev Nephrol. 2010, 6 (9): 521-529. 10.1038/nrneph.2010.100.CrossRefPubMed Prowle JR, Bellomo R: Continuous renal replacement therapy: recent advances and future research. Nat Rev Nephrol. 2010, 6 (9): 521-529. 10.1038/nrneph.2010.100.CrossRefPubMed
Metadata
Title
Alcohol-induced severe acute pancreatitis followed by hemolytic uremic syndrome managed with continuous renal replacement therapy
Authors
Peng Fu
Ai-hong Yuan
Chun-hua Wang
Xin Li
Hai-yang Wu
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2014
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/1471-2369-15-1

Other articles of this Issue 1/2014

BMC Nephrology 1/2014 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.