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Remission of FSGS after Hemolytic Uremic Syndrome due to Streptococcus pneumoniae Peritonitis

Kathryn H Pade, Rachel M Lestz

Abstract


Background: Hemolytic Uremic Syndrome (HUS) resulting from streptococcal pneumoniae infection has been well described in association with pneumonia, empyema and bacteremia. However, it has not been well reported in association with S. pneumoniae as the causative agent of spontaneous bacterial peritonitis (SBP).

Case: We report the case of a 4 year-old patient with biopsy-proven focal segmental glomerulosclerosis (FSGS) who developed clinical SBP with S. pneumoniae bacteremia. The patient subsequently developed hemolytic uremic syndrome with associated renal failure, hemolysis, uremia and thrombocytopenia. The patient recovered from HUS and has remained in clinical remission of nephrotic syndrome with normal renal function since his recovery. He has not required any immunomodulatory or immunosuppressive therapy since his presentation over one year ago.

Conclusions: The patient’s clinical and laboratory recovery from FSGS suggests an immunologic mechanism for recovery and possible cure of this progressive disease.

 

Keywords: nephrotic syndrome, peritonitis, streptococcus pneumoniae, atypical hemolytic uremic syndrome, proteinuria, remission


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