신이식후 발생한 용혈성 요독증후군 1예

Abstract

A hemolytic-uremic syndrome (HUS) in renal allograft recipients clinically is charaterized by microangiopathic hemolytic anemia, thrombocytopenia, hypertension and deterioration of graft function. De novo HUS usually occurs during cyclosporin-A (CyA) immunosuppression. The mechanisms that lead to CyA-associated HUS are not clear yet, but disturbance of prostacyclin synthesis in endothelial surface is suspected. We are reporting a case of CyA-associated HUS in a 30 year old female renal allograft recipient who received a kidney from her 52 year old mother. She developed hemolytic anemia, thrombocytopenia, hypertension and a gradual rise of serum creatinine level on the second day of transplantation. Initially she was given steroid pulse therapy under the assumption of acute rejection, without improvment. On the 12th day CyA treatment was discontinued and a percutaneous allograft biopsy was performed on the 17th day after transplantation. Histolgy of the graft showed numerous thrombi in the glomeruli capillary lumen and arterioles with fibrin deposits. Partial recovery of graft function occurred after cessation of CyA treatment.