Consanguineous hemolytic uremic syndrome secondary to Escherichia coli O157:H7 infection treated with aggressive therapeutic plasma exchange

We describe the successful management of an elderly husband and wife with Escherichia coli O157:H7 associated hemolytic uremic syndrome (HUS) treated with aggressive therapeutic plasma exchange (TPE) with replacement with fresh frozen plasma. Following twelve TPEs (three 1.5 volume; nine 1 volume), the husband's platelet count increased from 45 × 10 9 /L to 183 × 10 9 /L. Following ten 1.5 volume TPEs, the wife's platelet count increased from 30 × 10 9 /L to 193 × 10 9 /L. This is the first known occurrence of E. coli O157:H7 associated HUS in an elderly husband and wife successfully treated with aggressive TPE. We conclude that early, aggressive TPE should be considered and may be life‐saving for E coli O157:H7 associated HUS in the elderly. J. Clin. Aperesis 16:155–156, 2001 © 2001 Wiley‐Liss, Inc.