Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8164
Peer-review started: April 26, 2021
First decision: May 24, 2021
Revised: May 29, 2021
Accepted: July 28, 2021
Article in press: July 28, 2021
Published online: September 26, 2021
The occurrence of Streptococcus pneumoniae-associated hemolytic uremic syndrome (SP-HUS) is increasing. Thomsen-Friedenreich antigen activation is highly involved in the pathogenesis of SP-HUS, and T-antibody-negative plasma exchange (PE) may be effective in the treatment of severe cases of SP-HUS.
We retrospectively reviewed two pediatric patients with SP-HUS. Both clinical features and laboratory examination results of the children were described. T-antibody-negative PE was performed in both cases. Both children made a full recovery after repeated PE and remained well at a 2 year follow-up.
Streptococcal pneumonia continues to be an uncommon but important cause of HUS. The successful treatment of the presented cases suggests that T-antibody-negative PE may benefit patients with SP-HUS.
Core Tip: We present the cases of two pediatric patients with atypical hemolytic uremic syndrome associated with Streptococcus pneumoniae-hemolytic uremic syndrome that was successfully treated by T-antibody-negative plasma exchange. The patients were followed up for 2 years with normalization of all laboratory parameters, normal blood pressure and normal renal function.