Bloody Diarrhea-Associated Hemolytic Uremic Syndrome-Thrombotic Thrombocytopenic Purpura: A Case Report

Hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are termed HUS-TTP since their clinical features are alike. A 42-year-old female with abdominal pain and bloody diarrhea for two days was admitted to the hospital. She had a history of antibiotic therapy ten days before for upper respiratory tract infection. At physical examination, body temperature was 36.6°C and she had abdominal tenderness, but other systems were normal. During follow up, the patient developed hemolytic anemia, thrombocytopenia and acute renal failure which led to HUS-TTP. Stool examination did not reveal any microorganism or verotoxin. Due to the worsening clinical status and laboratory findings, plasmapheresis was performed. Shortly after plasmapheresis, the patient survived and renal failure resolved completely. Herewith, we have reviewed the relevant literature on HUS-TTP and emphasized that plasmapheresis-based treatment for TTP may be life-saving even though treatment of HUS is symptomatic.