Hemolytic Uremic Syndrome-associated Encephalopathy Successfully Treated with Corticosteroids

Intern Med. 2017 Nov 1;56(21):2937-2941. doi: 10.2169/internalmedicine.8341-16. Epub 2017 Sep 25.

Abstract

The encephalopathy that occurs in association with hemolytic uremic syndrome (HUS), which is caused by enterohemorrhagic Escherichia coli (E. coli), has a high mortality rate and patients sometimes present sequelae. We herein describe the case of a 20-year-old woman who developed encephalopathy during the convalescent stage of HUS caused by E.coli O26. Hyperintense lesions were detected in the pons, basal ganglia, and cortex on diffusion-weighted brain MRI. From the onset of HUS encephalopathy, we treated the patient with methylprednisolone (mPSL) pulse therapy alone. Her condition improved, and she did not present sequelae. Our study shows that corticosteroids appear to be effective for the treatment of some patients with HUS encephalopathy.

Keywords: diffusion-weighted imaging; encephalopathy; enterohemorrhagic Escherichia coli O26; hemolytic uremic syndrome; magnetic resonance imaging; methylprednisolone pulse.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Brain / pathology
  • Brain Diseases / complications*
  • Enterohemorrhagic Escherichia coli
  • Escherichia coli Infections / complications*
  • Female
  • Hemolytic-Uremic Syndrome / complications*
  • Hemolytic-Uremic Syndrome / drug therapy*
  • Hemolytic-Uremic Syndrome / etiology
  • Humans
  • Young Adult

Substances

  • Adrenal Cortex Hormones