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신이식후 발생한 용혈성 요독증후군 1예 |
박성배 , 김현철 , 박관규 , 권건영 |
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Abstract |
A hemolytic-uremic syndrome (HUS) in renal allo- graft recipients clinically is charaterized by mi- croangiopathic hemolytic anemia, thrombocytopenia, hypertension and deterioration of graft function. De novo HUS usually occurs during cyclosporin-A (CyA) immunosuppression. The mechanisms that lead to CyA- associated HUS are not clear yet, but disturbance of prostacyclin synthesis in endothelial surface is suspect- ed. We are reporting a case of CyA-associated HUS in a 30 year old female renal allograft recipient who received a kidney fr'om her 52 year old mother. She developed hemolytic anemia, thrombocytopenia, hyper- tension and a gradual rise of serum creatinine level on the second day of transplantation. Initially she was given steroid pulse therapy under the assumption of acute rejection, without improvement. On the 12th day CyA treatment was discontinued and a percutaneous allograft biopsy was performed on the 17th day after transplantation. Histolgy of the graft showed numerous thrombi in the glomeruli capillary lumen and arterioles with fibrin deposits. Partial recovery of graft function occurred after cessation of CyA treatment. |
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