DOI 10.5414/CN107691

Clinical Nephrology, Volume 81 - April (302 - 306)

Hemolytic uremic syndrome associated with Clostridium difficile infection

Anthony S. Alvarado1, Sergey V. Brodsky2, Tibor Nadasdy2, Neeraj Singh1, 3
1 Division of Nephrology, 2 Department of Pathology, Ohio State University, Columbus, OH, 3 Department of Internal Medicine, Division of Nephrology, Louisiana State University Health Sciences Center, Shreveport, LA, USA

Abstract

We report 3 cases of Clostridium difficile-associated hemolytic uremic syndrome (HUS) with biopsy proven renal thrombotic microangiopathy. Two patients with acute renal failure were kidney transplants recipients whereas the third patient developed renal failure in the native kidneys. The presentation was preceded by acute diarrhea and stool. Clostridium difficile toxin was detected in all the 3 patients. Stool studies were negative for Escherichia coli, Shigella dysenteriae and other enteric pathogens. The diagnosis of Clostridium difficile-associated hemolytic uremic syndrome was suspected due to presence of thrombocytopenia, microangiopathic hemolytic anemia and biopsy proven renal thrombotic microangiopathy without another clinically apparent cause. This case series suggest that Clostridium difficile infection may cause renal failure due to thrombotic microangiopathy (TMA) and should be considered in the differential diagnosis of diarrhea-associated HUS.

Author Details

Authors

  • Anthony S. Alvarado1
  • Sergey V. Brodsky2
  • Tibor Nadasdy2
  • Neeraj Singh1
  • 3

Departments

  • 1 Division of Nephrology,
  • 2 Department of Pathology, Ohio State University, Columbus, OH,
  • 3 Department of Internal Medicine, Division of Nephrology, Louisiana State University Health Sciences Center, Shreveport, LA, USA

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