| A Case of Digital Gangrene Complicated by Atypical Hemolytic Uremic Syndrome in a Patient with Systemic Lupus Erythematosus |
| Hea Yon Lee, M.D., Jin-Sun Jang, M.D., Hyung Wook Kim, M.D., Young Soo Kim, M.D., Young Ok Kim, M.D. and Sun Ae Yoon, M.D. |
| Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea |
| 증례 : 루푸스 환자에서 비전형적 용혈요독증후군에 합병된 사지 말단부 괴저 1예 |
| 이혜연, 장진선, 김형욱, 김영수, 김영옥, 윤선애 |
| 가톨릭대학교 의과대학 내과학교실 |
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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. |
| Key Words:
Gangrene, Hemolytic-Uremic syndrome, Lupus erythematosus, systemic, Sepsis |
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