Dilated Cardiomyopathy during the Course of Hemolytic Uremic Syndrome

Abstract

A 47-year-old woman presented with severe hemolytic uremic syndrome (HUS) followed by heart failure. An echocardiogram showed an ejection fraction of 20%, and a cardiac catheterization followed by a myocardial histologic evaluation demonstrated dilated cardiomyopathy. Plasma exchange and hemodialysis were performed regularly. The later outcomes of renal function and cardiomyopathy were favorable. A review of the literature confirmed the rare and severe nature of cardiac lesions occurring in the course of HUS. This case indicates the importance of cardiac monitoring in HUS and the need for prolonged support.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Ridolfi RL, Hutchins GM, Bell WR. The heart and cardiac conduction system in thrombotic thrombocytopenic purpura: a clinicopathologic study of 17 autopsied patients.Ann Intern Med. 1979;91:357–363.

    Article  CAS  Google Scholar 

  2. 2.

    Abu-Arafeh I, Gray E, Youngson G, Auchterlonie I, Russell G. Myocarditis and haemolytic uraemic syndrome.Arch Dis Child. 1995;72:46–47.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. 3.

    Podolsky SH, Zembowicz A, Schoen FJ, Benjamin RJ, Sonna LA. Massive myocardial necrosis in thrombotic thrombocytopenic purpura: a case report and review of the literature.Arch Pathol Lab Med. 1999;123:937–940.

    PubMed  CAS  Google Scholar 

  4. 4.

    Webb JG, Butany J, Langer G, Scott G, Liu PP. Myocarditis and myocardial hemorrhage associated with thrombotic thrombocytopenic purpura.Arch Intern Med. 1990;150:1535–1537.

    Article  CAS  Google Scholar 

  5. 5.

    Wajima T, Johnson EH. Sudden cardiac death from thrombotic thrombocytopenic purpura.Clin Appl Thromb Hemost. 2000;6: 108–110.

    Article  PubMed  CAS  Google Scholar 

  6. 6.

    Walker AM, Benson LN, Wilson GJ, Arbus GS. Cardiomyopathy: a late complication of hemolytic uremic syndrome.Pediatr Nephrol. 1997;11:221–222.

    Article  PubMed  CAS  Google Scholar 

  7. 7.

    Gallo EG, Gianantonio CA. Extrarenal in volvement in diarrhoea-associated haemolytic-uraemic syndrome.Pediatr Nephrol. 1995;9:117–119.

    Article  PubMed  CAS  Google Scholar 

  8. 8.

    Argyle JC, Hogg RJ, Pysher TJ, Silva FG, Siegler RL. A clinico-pathological study of 24 children with hemolytic uremic syndrome: a report of the Southwest Pediatric Nephrology Study Group.Pediatr Nephrol. 1990;4:52–58.

    Article  PubMed  CAS  Google Scholar 

  9. 9.

    Burke AP, Mont E, Kolodgie F, Virmani R. Thrombotic thrombocytopenic purpura causing rapid unexpected death: value of CD61 immunohistochemical staining in diagnosis.Cardiovasc Pathol. 2005;14:150–155.

    Article  PubMed  Google Scholar 

  10. 10.

    Ray CG, Portman JN, Stamm SJ, Hickman RO. Hemolyticuremic syndrome and myocarditis: association with coxsackievirus B infection.Am J Dis Child. 1971;122:418–420.

    Article  PubMed  CAS  Google Scholar 

  11. 11.

    Poulton J, Taylor CM, De Giovanni JV. Dilated cardiomyopathy associated with haemolytic uraemic syndrome.Br Heart J. 1987;57:181–183.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  12. 12.

    Taylor CM, White RH, Winterborn MH, Rowe B. Haemolytic-uraemic syndrome: clinical experience of an outbreak in the West Midlands.BMJ. 1986;292:1513–1516.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. 13.

    Cosmai EM, Puzis L, Tsai HM, Lian EC. Thrombocytopenic purpura and cardiomyopathy in pregnancy reversed by combined plasma exchange and infusion.Eur J Haematol. 2002;68:239–242.

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding authors

Correspondence to Alexandra Alexopoulou or Spyros P. Dourakis or Christos Zovoilis or Emmanouel Agapitos or Aris Androulakis or Anna Filiotou or Athanasios J. Archimandritis.

About this article

Cite this article

Alexopoulou, A., Dourakis, S.P., Zovoilis, C. et al. Dilated Cardiomyopathy during the Course of Hemolytic Uremic Syndrome. Int J Hematol 86, 333–336 (2007). https://doi.org/10.1532/IJH97.E0713

Download citation

Key words

  • Hemolytic uremic syndrome
  • Heart failure
  • Cardiomyopathy