Alcohol-induced severe acute pancreatitis followed by hemolytic uremic syndrome managed with continuous renal replacement therapy

BMC Nephrol. 2014 Jan 6:15:1. doi: 10.1186/1471-2369-15-1.

Abstract

Background: Acute kidney injury in patients with acute pancreatitis carries a poor prognosis. Hemolytic uremic syndrome (HUS) is characterized by non-immune hemolytic anemia, thrombocytopenia, and renal failure caused by platelet thrombi in the microcirculation of the kidney, and though rare in adults it is associated with high mortality and a high rate of chronic renal failure.

Case presentation: Herein, we report a case of alcohol-induced acute pancreatitis in a 38-year-old Chinese female complicated by HUS. Her renal function progressively deteriorated in 2 days, and daily continuous renal replacement therapy (CRRT) was thus performed for a total of 13 treatments. She also received intermittent transfusions of fresh frozen plasma. Her renal failure was successfully managed, with subsequent return of normal renal function. She was discharged 1 month after admission and follow-up at 3 months revealed normal urea and creatinine.

Conclusion: CRRT was shown to be useful for the treatment of HUS following acute pancreatitis. Prior case reports and our case should remind clinicians that HUS is a possible complication of acute pancreatitis. This study highlights the importance of early diagnosis and prompt initiation of CRRT to prevent mortality and improve outcomes.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alcoholic Intoxication / complications*
  • Alcoholic Intoxication / diagnosis
  • Alcoholic Intoxication / therapy*
  • Combined Modality Therapy
  • Female
  • Hemolytic-Uremic Syndrome / diagnosis
  • Hemolytic-Uremic Syndrome / etiology*
  • Hemolytic-Uremic Syndrome / therapy*
  • Humans
  • Pancreatitis, Alcoholic / complications*
  • Pancreatitis, Alcoholic / etiology*
  • Plasma Exchange
  • Renal Replacement Therapy*
  • Treatment Outcome