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Cholelithiasis Associated With the Hemolytic-Uremic Syndrome

Cholelithiasis Associated With the Hemolytic-Uremic Syndrome Abstract The hemolytic-uremic syndrome (HUS) exhibits a prodrome characterized by prominent gastrointestinal (GI) symptoms including vomiting, diarrhea that is often bloody, and colicky abdominal pain.1-3 Persistent vomiting and abdominal pain continued after return of normal renal function and cessation of hemolysis in a 15-year-old girl with severe HUS. She was found to have cholecystitis because of calcium bilirubinate stones, which developed as a consequence of hemolysis. Cholelithiasis occurring as a complication of HUS has not previously been reported. Report of a Case.—A previously healthy 15-year-old girl had anuria after five days of vomiting and bloody diarrhea. The diagnosis of HUS was made because of renal failure, anemia, thrombocytopenia, and the presence of many schistocytes on peripheral smear. The patient was then transferred to the Children's Hospital of Michigan, Detroit, where she remained anuric for 11 days. She required eight hemodialysis treatments and four transfusions of packed RBCs. Platelet counts References 1. Whitington PF, Friedman AL, Chesney RW: Gastrointestinal disease in the hemolytic-uremic syndrome . Gastroenterology 76:728-733, 1979. 2. Lieberman E: Hemolytic-uremic syndrome . J Pediatr 80:1-16, 1972.Crossref 3. Gianantonio CA: Hemolytic-uremic syndrome , in Edelmann CM Jr (ed): Pediatric Kidney Disease . Boston, Little Brown & Co, 1978, pp 724-736. 4. Salt WB, Schenker S: Amylase: Its clinical significance . Medicine 55:269-289, 1976.Crossref 5. Tedesco FJ, Harter HR, Alpers DH: Serum amylase determinations and amylase to creatinine clearance ratios in patients with chronic renal insufficiency . Gastroenterology 71:594-598, 1976. 6. Berk JE, Fridhandler L, Ness RL: Amylase and isoamylase activities in renal insufficiency . Ann Intern Med 90:351-353, 1979.Crossref 7. Sleisenger MH, Fordtran JS: Gastrointestinal Disease: Pathophysiology, Diagnosis, Management . Philadelphia, WB Saunders Co, 1978, pp 1248-1263. 8. Sarnaik S, Slovis T, Corbett D, et al: Incidence of cholelithiasis in sickle-cell anemia using the grey-scale ultrasonic technique . J Pediatr , to be published. 9. Bates GC, Brown CH: Incidence of gallbladder disease in chronic hemolytic anemia (spherocytosis) . Gastroenterology 21:104-109, 1952. 10. Bennion LJ, Grundy SM: Risk factors for the development of cholelithiasis in man . N Engl J Med 299:1161-1166, 1221-1226, 1978.Crossref 11. Crade M: Comparison of ultrasound and oral cholecystogram in the diagnosis of gallstones , in Taylor KJW (ed): Diagnostic Ultrasound in Gastrointestinal Disease . New York, Churchill Livingstone, 1979, pp 123-135. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Cholelithiasis Associated With the Hemolytic-Uremic Syndrome

Abstract

Abstract The hemolytic-uremic syndrome (HUS) exhibits a prodrome characterized by prominent gastrointestinal (GI) symptoms including vomiting, diarrhea that is often bloody, and colicky abdominal pain.1-3 Persistent vomiting and abdominal pain continued after return of normal renal function and cessation of hemolysis in a 15-year-old girl with severe HUS. She was found to have cholecystitis because of calcium bilirubinate stones, which developed as a consequence of hemolysis. Cholelithiasis...
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References (13)

Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1980.02130180078023
Publisher site
See Article on Publisher Site

Abstract

Abstract The hemolytic-uremic syndrome (HUS) exhibits a prodrome characterized by prominent gastrointestinal (GI) symptoms including vomiting, diarrhea that is often bloody, and colicky abdominal pain.1-3 Persistent vomiting and abdominal pain continued after return of normal renal function and cessation of hemolysis in a 15-year-old girl with severe HUS. She was found to have cholecystitis because of calcium bilirubinate stones, which developed as a consequence of hemolysis. Cholelithiasis occurring as a complication of HUS has not previously been reported. Report of a Case.—A previously healthy 15-year-old girl had anuria after five days of vomiting and bloody diarrhea. The diagnosis of HUS was made because of renal failure, anemia, thrombocytopenia, and the presence of many schistocytes on peripheral smear. The patient was then transferred to the Children's Hospital of Michigan, Detroit, where she remained anuric for 11 days. She required eight hemodialysis treatments and four transfusions of packed RBCs. Platelet counts References 1. Whitington PF, Friedman AL, Chesney RW: Gastrointestinal disease in the hemolytic-uremic syndrome . Gastroenterology 76:728-733, 1979. 2. Lieberman E: Hemolytic-uremic syndrome . J Pediatr 80:1-16, 1972.Crossref 3. Gianantonio CA: Hemolytic-uremic syndrome , in Edelmann CM Jr (ed): Pediatric Kidney Disease . Boston, Little Brown & Co, 1978, pp 724-736. 4. Salt WB, Schenker S: Amylase: Its clinical significance . Medicine 55:269-289, 1976.Crossref 5. Tedesco FJ, Harter HR, Alpers DH: Serum amylase determinations and amylase to creatinine clearance ratios in patients with chronic renal insufficiency . Gastroenterology 71:594-598, 1976. 6. Berk JE, Fridhandler L, Ness RL: Amylase and isoamylase activities in renal insufficiency . Ann Intern Med 90:351-353, 1979.Crossref 7. Sleisenger MH, Fordtran JS: Gastrointestinal Disease: Pathophysiology, Diagnosis, Management . Philadelphia, WB Saunders Co, 1978, pp 1248-1263. 8. Sarnaik S, Slovis T, Corbett D, et al: Incidence of cholelithiasis in sickle-cell anemia using the grey-scale ultrasonic technique . J Pediatr , to be published. 9. Bates GC, Brown CH: Incidence of gallbladder disease in chronic hemolytic anemia (spherocytosis) . Gastroenterology 21:104-109, 1952. 10. Bennion LJ, Grundy SM: Risk factors for the development of cholelithiasis in man . N Engl J Med 299:1161-1166, 1221-1226, 1978.Crossref 11. Crade M: Comparison of ultrasound and oral cholecystogram in the diagnosis of gallstones , in Taylor KJW (ed): Diagnostic Ultrasound in Gastrointestinal Disease . New York, Churchill Livingstone, 1979, pp 123-135.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jun 1, 1980

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