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Norovirus: a novel etiologic agent in hemolytic uremic syndrome in an infant
BACKGROUND: Hemolytic uremic syndrome is a rare thrombotic microangiopathy usually seen in infants and children below the age of 5 years. It usually follows a bout of bloody diarrhea caused by Shiga toxin producing E coli and is characterized by microangiopathic hemolytic anemia, thrombocytopenia an...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612073/ https://www.ncbi.nlm.nih.gov/pubmed/31277594 http://dx.doi.org/10.1186/s12882-019-1427-6 |
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author | Abu Daher, Ghadi Aoun, Bilal Jaafar, Fatima Khafaja, Sarah Sanjad, Sami |
author_facet | Abu Daher, Ghadi Aoun, Bilal Jaafar, Fatima Khafaja, Sarah Sanjad, Sami |
author_sort | Abu Daher, Ghadi |
collection | PubMed |
description | BACKGROUND: Hemolytic uremic syndrome is a rare thrombotic microangiopathy usually seen in infants and children below the age of 5 years. It usually follows a bout of bloody diarrhea caused by Shiga toxin producing E coli and is characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury. We report the first case of hemolytic uremic syndrome in an infant following Norovirus gastroenteritis. CASE PRESENTATION: A nine-month-old male infant, was admitted with an 8-day history of watery, non-bloody diarrhea, vomiting and decreased oral intake. Physical exam revealed normal blood pressure, pallor and generalized edema. Laboratory findings were significant for microangiopathic hemolytic anemia, thrombocytopenia and azotemia. Stool studies with Multiplex Qualitative reverse transcriptase PCR were positive for Norovirus GI/G II. His clinical course was unusually severe, complicated by oligoanuria and worsening uremia requiring peritoneal dialysis but with eventual complete recovery. CONCLUSIONS: To our knowledge this is the first case of Norovirus associated HUS in an infant. Given the ubiquity of this virus as a major cause of diarrhea, together with the increased availability of Multiplex Qualitative PCR in reference laboratories, it is quite possible that we shall be seeing more such cases in the future. |
format | Online Article Text |
id | pubmed-6612073 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66120732019-07-16 Norovirus: a novel etiologic agent in hemolytic uremic syndrome in an infant Abu Daher, Ghadi Aoun, Bilal Jaafar, Fatima Khafaja, Sarah Sanjad, Sami BMC Nephrol Case Report BACKGROUND: Hemolytic uremic syndrome is a rare thrombotic microangiopathy usually seen in infants and children below the age of 5 years. It usually follows a bout of bloody diarrhea caused by Shiga toxin producing E coli and is characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury. We report the first case of hemolytic uremic syndrome in an infant following Norovirus gastroenteritis. CASE PRESENTATION: A nine-month-old male infant, was admitted with an 8-day history of watery, non-bloody diarrhea, vomiting and decreased oral intake. Physical exam revealed normal blood pressure, pallor and generalized edema. Laboratory findings were significant for microangiopathic hemolytic anemia, thrombocytopenia and azotemia. Stool studies with Multiplex Qualitative reverse transcriptase PCR were positive for Norovirus GI/G II. His clinical course was unusually severe, complicated by oligoanuria and worsening uremia requiring peritoneal dialysis but with eventual complete recovery. CONCLUSIONS: To our knowledge this is the first case of Norovirus associated HUS in an infant. Given the ubiquity of this virus as a major cause of diarrhea, together with the increased availability of Multiplex Qualitative PCR in reference laboratories, it is quite possible that we shall be seeing more such cases in the future. BioMed Central 2019-07-05 /pmc/articles/PMC6612073/ /pubmed/31277594 http://dx.doi.org/10.1186/s12882-019-1427-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Abu Daher, Ghadi Aoun, Bilal Jaafar, Fatima Khafaja, Sarah Sanjad, Sami Norovirus: a novel etiologic agent in hemolytic uremic syndrome in an infant |
title | Norovirus: a novel etiologic agent in hemolytic uremic syndrome in an infant |
title_full | Norovirus: a novel etiologic agent in hemolytic uremic syndrome in an infant |
title_fullStr | Norovirus: a novel etiologic agent in hemolytic uremic syndrome in an infant |
title_full_unstemmed | Norovirus: a novel etiologic agent in hemolytic uremic syndrome in an infant |
title_short | Norovirus: a novel etiologic agent in hemolytic uremic syndrome in an infant |
title_sort | norovirus: a novel etiologic agent in hemolytic uremic syndrome in an infant |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612073/ https://www.ncbi.nlm.nih.gov/pubmed/31277594 http://dx.doi.org/10.1186/s12882-019-1427-6 |
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