Hemolytic uremic syndrome in severe acute pancreatitis

重症急性胰腺炎并发溶血性尿毒综合征

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Abstract

INTRODUCTION: Hemolytic Uremic Syndrome is characterized by Coombs negative microangiopathic hemolytic anemia, severe thrombocytopenia, and acute kidney injury. CASE REPORT: Here, we report a 36-year-old male, a case of alcohol related acute pancreatitis. On day 5, he developed fever and tachycardia. Evaluation revealed thrombocytopenia, hemolytic anemia, and acute kidney injury with low C3, normal C4 & ADAMTS13 activity and positive anti-complement factor H antibody. He was diagnosed as a case of Hemolytic Uremic Syndrome and managed with plasmapheresis, hemodialysis, and Intravenous immunoglobulin. He was administered Rituximab on day 15, considering the refractory nature of the disease. Despite the aggressive management, he succumbed to his illness. CONCLUSION: This case highlights atypical Hemolytic Uremic Syndrome as a rare complication of Acute Pancreatitis. Our patient, despite being diagnosed well in time and managed aggressively, had an unfavourable outcome. This condition should be diagnosed well in time, as it is associated with high mortality.

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