Hasvi Jayaraj, Bhatia Inder Preet Singh, Dawra Saurabh, Singh Amulyajit, Tripathi Siddharth
Department of Internal Medicine, Military Hospital, Bareilly 243001, Bareilly district, India.
Department of Internal Medicine, 167 Military Hospital, Pathankot 145001, Pathankot district, India.
Oxf Med Case Reports. 2025 May 28;2025(5):omaf048. doi: 10.1093/omcr/omaf048. eCollection 2025 May.
Hemolytic Uremic Syndrome is characterized by Coombs negative microangiopathic hemolytic anemia, severe thrombocytopenia, and acute kidney injury.
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.
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.
溶血性尿毒症综合征的特征为库姆斯试验阴性的微血管病性溶血性贫血、严重血小板减少和急性肾损伤。
在此，我们报告一名36岁男性，患有酒精相关性急性胰腺炎。在第5天，他出现发热和心动过速。检查发现血小板减少、溶血性贫血和急性肾损伤，C3降低，C4正常，ADAMTS13活性正常，抗补体因子H抗体阳性。他被诊断为溶血性尿毒症综合征，并接受了血浆置换、血液透析和静脉注射免疫球蛋白治疗。考虑到疾病的难治性，在第15天给他使用了利妥昔单抗。尽管进行了积极治疗，他仍因病死亡。
本病例突出了非典型溶血性尿毒症综合征作为急性胰腺炎罕见并发症的情况。我们的患者尽管及时得到诊断并接受了积极治疗，但预后不佳。由于该疾病死亡率高，应及时进行诊断。
