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KMID : 0359920100290030392
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Korean Journal of Nephrology
2010 Volume.29 No. 3 p.392 ~ p.397
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A Case of Digital Gangrene Complicated by Atypical Hemolytic Uremic Syndrome in a Patient with Systemic Lupus Erythematosus
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Lee Hea-Yon
Jang Jin-Sun
Kim Hyung-Wook
Kim Young-Soo
Kim Young-Ok
Yoon Sun-Ae
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Abstract
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Atypical hemolytic uremic syndrome (HUS) in adults is a life-threatening disorder characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia, which is not related to E. coli. Digital gangrene is one of the grave signs in emergency medicine because it requires prompt evaluation and treatment. We describe a 37 year-old Thailand woman, initially treated for suspected Neisseria septicemia, who went on to develop renal complications, thrombocytopenia and hemolytic anemia, which made the diagnosis of atypical hemolytic uremic syndrome. The patient was complaining of dysesthesia on all extremities and severe pain in both legs. Serologically, she was diagnosed as systemic lupus erythematosus (SLE). She was treated with plasma exchanges using fresh frozen plasma, parenteral steroid, anticoagulant and antibiotics, successfully. This is the first report of digital gangrene complicated by atypical HUS in a patient with SLE in Korea.
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KEYWORD
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Gangrene, Hemolytic-Uremic syndrome, Lupus erythematosus, systemic, Sepsis
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