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A case of atypical hemolytic uremic syndrome as an early manifestation of acute lymphoblastic leukemia

Korean Journal of Pediatrics 2010;53(2):253-257.
Published online February 15, 2010.
A case of atypical hemolytic uremic syndrome as an early manifestation of acute lymphoblastic leukemia
Dong Kyun Han1, Hee Jo Baek1, Young Kuk Cho1, Chan Jong Kim1, Myung Geun Shin2, Hoon Kook1, Tai Ju Hwang1
1Departments of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea
2Departments of Laboratory Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea
비전형적 용혈성 요독 증후군으로 조기 발현한 급성 림프모구성 백혈병 1예
한동균1, 백희조1, 조국영1, 김찬종1, 신명근2, 국훈1, 황태주1
1전남대학교 의과대학 화순 전남대학교병원 소아과학교실
2전남대학교 의과대학 화순 전남대학교병원 진단검사의학과교실
Correspondence: 
Hoon Kook, Tel: +82.61-379-7696, Fax: +82.61-379-7697, Email: hoonkook@chonnam.ac.kr
Abstract
Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in children younger than 4 years and is characterized by microangiopathic hemolytic anemia, acute renal failure, and thrombocytopenia. HUS associated with diarrheal prodrome is usually caused by Shiga toxin-producing Escherichia coli O157:H7 or by Shigella dysenteriae, which generally has a better outcome. However, atypical cases show a tendency to relapse with a poorer prognosis. HUS has been reported to be associated with acute lymphoblastic leukemia (ALL) in children. The characteristics and the mechanisms underlying this condition are largely unknown. In this study, we describe the case of an 11-year-old boy in whom the diagnosis of ALL was preceded by the diagnosis of atypical HUS. Thus, patients with atypical HUS should be diagnosed for the possibility of developing ALL.
Key Words: Hemolytic uremic syndrome, Acute lymphoblastic leukemia, Acute renal failure


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