Complete Renal Recovery in Pediatric Patient with Streptococcus pneumoniae-Associated HUS: A Case Report and Literature Review

Abstract

Hemolytic uremic syndrome caused by invasive pneumococcal disease (Sp-HUS) is rare in children and adolescents, has a high mortality in the acute phase and is often complicated by long term renal sequelae. Here we report a 22-month-old female with no significant past medical history who was initially admitted for severe streptococcal pneumonia, which ultimately progressed to acute kidney injury and hemolytic anemia. Broad functional complement analysis showed low C3 and C4, and genetic complement analyses were negative. Coagulation studies were examined at the time of HUS diagnosis. The presence of normal fibrinogen levels associated with findings consistent with HUS was used to rule out disseminated intravascular coagulopathy (DIC). The patient required hemodialysis and received plasmapheresis. The patient did not receive C5 blockade. During a follow up time of 12 months, the patient showed no signs of renal sequelae.