Hemolytic-uremic syndrome associated with Streptococcus pneumoniae. Report of a case and review of the literature
U. Alon, S. P. Adler and J. C. Chan
A child aged 2 years 3 months with Streptococcus pneumoniae sepsis and
pulmonary abscesses had hemolytic-uremic syndrome and acute renal failure
develop that required 36 cycles of peritoneal dialysis. A percutaneous
renal biopsy specimen taken after dialysis showed mesangial proliferation
with interposition, hemorrhagic crescents, and intracapillary thrombosis
with fibrinogen and IgM deposition. The atrophic renal tubules showed
positive immunofluorescence against peanut agglutinin. Neuraminidase
released by pneumococcal organisms is thought to expose the
Thomsen-Friedenreich antigen on platelets, erythrocytes, and kidneys,
resulting in IgM deposition and binding of peanut agglutinin. Review of the
literature showed four other reports involving five children who had
hemolytic-uremic syndrome develop secondary to pneumococcal infections.
