Hemolytic uremic syndrome with simultaneous Shiga toxin producing Escherichia coli and complement abnormalities

BACKGROUND Hemolytic uremic syndrome is a common cause of acute kidney injury in children. In children, hemolytic uremic syndrome is most commonly associated with gastrointestinal infections caused by Shiga toxin-producing Escherichia coli or other enteric organisms. Although less common, atypical hemolytic uremic syndrome is triggered by multiple factors and portends a significantly worse prognosis with a high rate of recurrence. CASE PRESENTATION Here we discuss the case of a 10 year old Caucasian male presenting with thrombocytopenia, anemia, and acute kidney injury. CONCLUSIONS This case highlights the clinical challenges in diagnosing and managing patients with hemolytic uremic syndrome. Because of similarity in symptoms, differentiating Shiga toxin-producing Escherichia coli associated hemolytic uremic syndrome and atypical hemolytic uremic syndrome can be challenging. However, because of the increased morbidity and mortality of atypical hemolytic uremic syndrome, early detection and initiation of therapy are critical. Providers must have a heightened suspicion in order to initiate supportive care or disease directed therapy in the case of atypical hemolytic uremic syndrome.