All issues > Volume 53(2); 2010

Case Report

Korean J Pediatr. 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 DK Han¹, Hee Jo HJ Baek¹, Young Kuk YK Cho¹, Chan Jong CJ Kim¹, Myung Geun MG Shin², Hoon H Kook¹, Tai Ju TJ 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

Correspondence Hoon H 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.

Keywords :Hemolytic uremic syndrome, Acute lymphoblastic leukemia, Acute renal failure