Abstract
Hemolytic uremic syndrome (HUS) is a rare but life-threatening thrombotic microangiopathy in adults, classically characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. While pediatric HUS is commonly associated with Shiga toxin-producing Escherichia coli, adult presentations are often atypical and carry a higher risk of progression to chronic kidney disease or death. We present the case of a 49-year-old woman with acute renal failure and features of HUS, managed with hemodialysis and plasma exchange, emphasizing the diagnostic and therapeutic challenges in adult HUS.