An Atypical Case of Shiga Toxin Producing- Escherichia Coli Hemolytic and Uremic Syndrome (STEC-HUS) in a Lung Transplant Recipient

Louis Manière; Camille Domenger; Boubou Camara; Diane Giovannini; Paolo Malvezzi; Lionel Rostaing

doi:10.1155/2019/9465040

An Atypical Case of Shiga Toxin Producing- Escherichia Coli Hemolytic and Uremic Syndrome (STEC-HUS) in a Lung Transplant Recipient

Case Rep Transplant. 2019 Apr 11:2019:9465040. doi: 10.1155/2019/9465040. eCollection 2019.

Authors

Louis Manière^{1

2}, Camille Domenger¹, Boubou Camara³, Diane Giovannini^{2

4}, Paolo Malvezzi^{1

2}, Lionel Rostaing^{1

2}

Affiliations

¹ Service de Néphrologie, Hémodialyse, Aphérèses et Transplantation Rénale, CHU Grenoble-Alpes, Grenoble, France.
² Université Grenoble Alpes, Grenoble, France.
³ Service de Pneumologie, CHU Grenoble-Alpes, France.
⁴ Laboratoire d'Anatomie Pathologique, CHU Grenoble-Alpes, France.

Abstract

We herein describe the first case of thrombotic microangiopathy (TMA) which was related to Shiga toxin producing-Escherichia Coli Hemolytic and Uremic Syndrome (STEC-HUS) after lung transplantation. His maintenance immunosuppression relied on tacrolimus plus mycophenolic acid. TMA was treated with plasma exchanges (PE) (fresh frozen plasma substitution). After five days of PE, platelets count and lactate dehydrogenase level normalized, whereas hemoglobin continued to gradually decrease and no improvement in kidney function was observed. After seven PE sessions, all TMA biological signs resolved. However, kidney function did not improve, and the patient still required chronic dialysis.

Publication types

Case Reports