A Rare Cause of Hemolytic Uremic Syndrome: Salmonella Typhii

Yıl 2023, Cilt: 18 Sayı: 1, 209 - 211, 16.03.2023

İlyas Ozturk , Serdal Gök , Hatice Kübra Saylak , Ertuğrul Erken , Orçun Altunören , Özkan Güngör

https://doi.org/10.17517/ksutfd.1026255

Öz

Hemolytic uremic syndrome (HUS) is a serious disease characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure.
If an appropriate diagnosis and treatment is not initiated, it can be fatal. Infectious agents are generally blamed in the etiology. Generally, infections due
to microorganisms producing verocytotoxin (Shiga-like toxin) take an important place in etiology. Pathogens responsible for these infections were mostly
reported as Enterohemorrhagic Escherichia coli (EHEC), Shigella dysanteria type 1, and less frequently as Citrobacter freundi. More rarely, HUS cases due
to Streptococcus pneumoniae, HIV, Clostiridium difficile have been reported in the literature. This case is presented because of the detection of Salmonella
Typhii, as a very rare factor in the etiology of HUS, which developed in a 28-year-old male patient.

Anahtar Kelimeler

Hemolytic uremic syndrome , Infection , Salmonella

Nadir Bir Hemolitik Üremik Sendrom Nedeni: Salmonella Typhii

Öz

Hemolitik üremik sendrom (HÜS), mikroanjiyopatik hemolitik anemi, trombositopeni ve akut böbrek yetmezliği ile karakterize olan ciddi bir hastalıktır.
Hızlı tanı konulup uygun tedavi başlanmadığı takdirde ölümcül seyredebilir. Etyolojide enfeksiyöz ajanlar sıklıkla suçlanmaktadır. Genellikle verositotoksin
(Shiga benzeri toksin) üreten mikroorganizmalara bağlı enfeksiyonlar etyolojide önemli yer almaktadır. Bu enfeksiyonlardan sorumlu patojenler çoğunlukla
Enterohemorajik Escherichia coli (EHEC), Shigella dysanteria tip 1, nadir olarak da Citrobacter freundi olarak bildirilmiştir. Daha nadir olarak Streptococ-
cus pneumoniae, HIV, Clostiridium difficile’ye bağlı HÜS vakaları literatürde bildirilmiştir. Bu olgu, 28 yaşındaki erkek hastada gelişen HÜS tablosunun
etyolojisinde çok nadir görülen bir etken olan Salmonella Typhii’nin tespit edilmesi nedeniyle sunulmuştur.

Anahtar Kelimeler

Hemolitik üremik sendrom , Enfeksiyon , Salmonella

Kaynakça

• Noris M, Remuzzi G. Hemolytic uremic syndrome. J Am Soc Nephrol. 2005;16(4):1035-1050.
• Ruggenenti P, Noris M, Remuzzi G. Thrombotic microangiopathy, hemolytic uremic syndrome, and thrombotic thrombocytopenic purpura. Kidney Int. 2001;60(3):831-846.
• Albaqali A, Ghuloom A, Al Arrayed A, Al Ajami A, Shome DK, Jamsheer A et al. Hemolytic uremic syndrome in association with typhoid fever. Am J Kidney Dis. 2003;41(3):709-713.
• Butani L. Hemolytic uremic syndrome associated with Clostridium difficile colitis. Pediatr Nephrol. 2004;19(12):1430.
• Mele C, Remuzzi G, Noris M. Hemolytic uremic syndrome. Semin Immunopathol; 2014;36:399–420.
• Acheson D, Hohmann EL. Nontyphoidal salmonellosis. Clin Infect Dis. 2001;32(2):263-269.
• Boyce TG, Swerdlow DL, Griffin PM. Escherichia coli O157: H7 and the hemolytic–uremic syndrome. NEJM. 1995;333(6):364-368.
• Flores FX, Jabs K, Thorne GM, Jaeger J, Linshaw MA, Somers MJ. Immune response to Escherichia coli O157: H7 in hemolytic uremic syndrome following salmonellosis. Pediatr Nephrol. 1997;11(4):488-490.
• George P. & Pawar B. A sinister presentation of typhoid fever. Indian J Nephrol. 2007;17(4), 176-177.
• Baker NM, Mills AE, Rachman I, Thomas JE. Haemolytic Uraemic Syndrame in Typhoid fever. Br Med J. 1974;2:84-87
• Keenswijk W, Degraeuwe E, Dhont E, Raes A, Vande Walle J. Hemolytic uremic syndrome associated with non–shigatoxin-producing infectious agents: Expanding the Shigatoxin theory. J Pediatr Hematol Oncol. 2019;41(3):179-181.
• Wong CS, Jelacic S, Habeeb RL, Watkins SL, Tarr PI. The risk of the hemolytic–uremic syndrome after antibiotic treatment of Escherichia coli O157: H7 infections. NEJM. 2000;342(26):1930-1936.