PMID: 8604470Mar 1, 1996Paper

Hemolytic-uremic syndrome without evidence of microangiopathic hemolytic anemia on peripheral blood smear

Southern Medical Journal
S E BrilliantH M Cushner

Abstract

We report the case of an 18-year old man with hemolytic-uremic syndrome (HUS) having a classic clinical presentation and diagnostic renal pathology without evidence of microangiopathic hemolytic anemia (MAHA) by peripheral blood smear. Indirect evidence of hemolysis was suggested by mild anemia, elevation of serum lactate dehydrogenase, and examination of the patient's bone marrow. We postulate that in this case the inability to detect schistocytes in the peripheral smear reflected a low degree of hemolysis. Review of the literature revealed that evidence of fragmented erythrocytes by peripheral smear is not always present in HUS, yet this observation has received little attention. Thus, the diagnosis of HUS need not include overt evidence of MAHA as is traditionally taught.

Citations

Jun 10, 2003·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Trung NguyenJoseph A. Carcillo
Apr 9, 2005·Southern Medical Journal·Sumanth R DaramBahar Bastani
Nov 14, 2006·Critical Care : the Official Journal of the Critical Care Forum·Trung C Nguyen, Joseph A Carcillo
Mar 6, 2008·Journal of Veterinary Diagnostic Investigation : Official Publication of the American Association of Veterinary Laboratory Diagnosticians, Inc·Charles E DickinsonChitrita DebRoy
Jul 30, 2014·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Esra SevketogluJoseph A Carcillo

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