Hemolytic Uremic Syndrome and SARS-CoV-2 Infection: A Rare Association

• Autor(a) principal: Honrado Martins, Cristiana
• Data de Publicação: 2023
• Outros Autores: Damasceno Costa, José, Pereira, Paulo, Matos, Ana Rita, Gomes, Vânia, Castro Gomes, Guilherme
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.24950/rspmi.1616
• topic: COVID-19/complicações; SARS-CoV-2; Síndrome Hemolítica Urémica Atípica/diagnóstico; Síndrome Hemolítica Urémica Atípica/tratamento.; Atypical Hemolytic Uremic Syndrome/diagnosis; Atypical Hemolytic Uremic Syndrome/therapy; COVID-19/ complications; SARS-CoV-2

Thrombotic microangiopathies (TMA) are rare diseases,with high morbimortality. Among them, atypical hemolytic uremic syndrome (HUS), associated with deregulation of alternative complement pathway (genetic/acquired), represents a diagnostic challenge. Characterized by thrombotic microangiopathy, acute renal failure is one of its main features. Etiological/ precipitant detection (TMA triggers) is essential, even though about 30% of cases remain idiopathic. There is not a direct diagnostic test, which makes this an exclusion final diagnosis (after primary and secondary causes are ruled-out). Further testingfor genetic variations is important for prognostic purposes. We describe the case of a 40 years old woman, whosefinal diagnostic was an atypical HUS associated with SARS--CoV-2 infection. This case stands out by its rarity. We underline the importance of prompt initial diagnosis and timely target treatment beginning: Eculizumab, the only one available in Portugal at the moment. Plasmapheresis and/orrenal replacement therapy must be considered case by case.