Hemolytic uremic syndrome following COVID-19; a case report

Abstract

High incidence of thromboembolic diseases in patients with coronavirus disease 2019 (COVID-19) have been reported that can affect several organs ranging from cutaneous thrombosis to pulmonary embolism, stroke, coronary thrombosis or kidney infarction. There are two proposed mechanisms for these phenomena, disseminated intravascular coagulation (DIC) and endotheliopathy. We report a case of 11-year-old girl presented to the emergency department with generalized tonic colonic seizure with upward gaze which was repeated in emergency room. Respiratory distress and loss of consciousness happened which led to her intubation. Due to increased serum creatinine levels and impaired consciousness which was associated with thrombocytopenia and hemolysis, she underwent plasmapheresis three times by the diagnosis of hemolytic uremic syndrome. Additionally, antihypertensive therapy was conducted. The patient’s condition improved and was discharged with good circumstances. Two weeks later the patient returned with thromboembolism that happened in the distal part of her left hand which underwent fasciotomy and thrombectomy.