Hemolytic uremic syndrome with central nervous system manifestations, a case report and literature review.

Autor:	Mansour MA; Department of Neurology and Neurologic Surgery, Faculty of Medicine, Al-Azhar University, 1 Al-Mokhyam Al-Daem St., Nasr City, Cairo 11884, Egypt.; Department of Neurology and Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.; Division of Neuro-Intensive Care, Dar Al-Fouad Medical Corporation, Cairo, Egypt.; Department of Emergency Medicine and Critical Care, Faculty of Medicine, Al-Azhar University, 1 Al-Mokhyam Al-Daem St., Nasr City, Cairo 11884, Egypt., Khalil DF; Department of Emergency Medicine and Critical Care, Dubai Healthcare City, Dubai, UAE., Hasham MA; Department of Emergency Medicine and Critical Care, Faculty of Medicine, Al-Azhar University, 1 Al-Mokhyam Al-Daem St., Nasr City, Cairo 11884, Egypt., Youssef A; Department of Emergency Medicine and Critical Care, Faculty of Medicine, Al-Azhar University, 1 Al-Mokhyam Al-Daem St., Nasr City, Cairo 11884, Egypt., Rashad M; Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Awadallah M; Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt., Ali H; Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.; Division of Neurology and Neurodevelopmental Disorders, Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Jazyk:	angličtina
Zdroj:	Radiology case reports [Radiol Case Rep] 2023 Apr 18; Vol. 18 (6), pp. 2268-2273. Date of Electronic Publication: 2023 Apr 18 (Print Publication: 2023).
DOI:	10.1016/j.radcr.2023.02.035
Abstrakt:	Hemolytic uremic syndrome (HUS) is a multisystem disorder generally seen in children and young adults, manifesting with the symptomatic triad of thrombocytopenia, hemolytic anemia, and acute kidney injury. These symptoms are often preceded by a prodrome of bloody diarrhea, vomiting, fever, and weakness. HUS is an exceedingly rare entity, with less than 1.5 per 100,000 people affected annually. HUS with central nervous system (CNS) manifestations constitutes approximately 20%-50% of cases and often presents with seizures, altered level of consciousness, and brainstem symptoms. CNS involvement in HUS is a major cause of acute morbidity and mortality; therefore, timely diagnosis and treatment are crucial in the management of these cases. Neuroimaging plays a critical role in the diagnosis; however, it might be very challenging in a large number of cases because studies that report the typical neuroradiologic features of brain injury in cases with HUS are not commonly available. Herein, we demonstrate in a case-based approach, the importance of combining clinical suspicion with different radiologic modalities to better characterize HUS cases with CNS involvement, as well as demonstrate how the early start of meticulous supportive therapy can lead to a favorable outcome even when severe brain involvement is evident on acute imaging studies. Furthermore, we provide an illustrated overview of the current theories that explain the neurologic involvement in HUS, as well as the commonly affected brain areas and how this entity can be radiologically differentiated from other potential diagnoses. (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
Databáze:	MEDLINE
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