Plasma Exchange in the Treatment of Cyclosporine Induced Hemolytic Uremic Syndrome Following Kidney Transplantaion / 대한임상병리학회지

ABSTRACT

Hemolytic uremic syndrome is characterized by a triad of clinical findings including microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The precise etiology and pathogenesis of hemolytic uremic syndrome are not established by now. According to clinical reports, hemolytic uremic syndrome is associated with infection(bacteria, virus), connective tissue disease, malignancy, drug and pregnancy. Recently, many investigators have reported that cyclosporine induces hemolytic uremic syndrome. Cyclosporine is one of the immunosuppressants that are essential for kidney transplantation. We experienced one case of hemolytic uremic syndrome that developed after kidney transplantation receiving cyclosporine. A 43-yr-old woman with end-stage renal failure received kidney transplantation from her daughter. After operation, she received cyclosporine for immunosuppression and thrombocytopenia, microangiopathic hemolytic anemia and acute renal failure were developed. She was diagnosed as cyclosporine induced hemolytic uremic syndrome and plasma exchange was started with fresh frozen plasma. The plasma exchange was done 16 times and the clinical symptoms were improved. We present this case with review of literatures.