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Haemolytic‐uraemic syndrome during severe lupus nephritis: efficacy of plasma exchange
Author(s) -
Samson M.,
Audia S.,
Leguy V.,
Berthier S.,
Janikashvili N.,
Martin L.,
Bonnotte B.,
Lorcerie B.
Publication year - 2012
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/j.1445-5994.2011.02591.x
Subject(s) - medicine , thrombotic microangiopathy , thrombotic thrombocytopenic purpura , lupus nephritis , schistocyte , haemolytic uraemic syndrome , microangiopathic hemolytic anemia , microangiopathy , hemolytic anemia , immunology , cyclophosphamide , therapeutic plasma exchange , systemic lupus erythematosus , coombs test , chemotherapy , endocrinology , platelet , disease , antibody , biochemistry , chemistry , escherichia coli , gene , diabetes mellitus
Systemic lupus erythematosus (SLE) has been described as a cause of thrombotic microangiopathy, especially thrombotic thrombocytopenic purpura (TTP). Haemolytic‐uraemic syndrome (HUS) is less frequent in SLE. We report a case of such an association during an episode of severe lupus nephritis in a young woman, who was successfully treated with steroids, cyclophosphamide and especially plasma exchange with plasma replacement. This report highlights the importance of recognising atypical HUS in SLE patients by looking for schistocytes in case of haemolytic anemia with a negative antiglobulin test, in order to begin plasma exchange.