허혈성 대장염에 동반된 용혈성 요독 증후군 1례
A Case of Hemolytic Uremic Syndrome in a Child with Ischemic Colitis
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저자들은 복통과 구토, 혈변을 주소로 내원한 환아의 바륨 대장 조영술에서 무지문양(thumbprinting)을 확인하여 허혈성 대장염 진단하에 치료 중 미세혈관성 용혈성 빈혈과 혈소판 감소, 전해질 불균형과 급격한 소변량 감소의 급성 신부전 소견을 확인하고 허혈성 대장염에 동반된 용혈성 요독 증후군을 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Hemolytic uremic syndrome(HUS) is characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia and the most common pathogen is Escherichia coli (E. coli) O157:H7. Ischemic colitis, which rarely occurs in children, is due to the reduced local blood flow to the intestine, tissue necrosis and secondary bacterial infection. We describe a patient who was admitted with abdominal pain, vomiting and hematochezia, and diagnosed as ischemic colitis by barium enema. This patient showed hemolytic anemia, thrombocytopenia and progressive renal failure and was subsequently diagnosed as hemolytic uremic syndrome. After hemodialysis, the patient showed improvement of symptoms and resolution of renal failure and ischemic colitis.
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