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Report of a Case and Review of the Literature

Uri Alon, MD; Stuart P. Adler, MD; James C. M. Chan, MD

Am J Dis Child. 1984;138(5):496-499.

Abstract
• 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.

(AJDC 1984;138:496-499)

Author Affiliations
From the Department of Pediatrics, Medical College of Virginia, Richmond (Drs Alon, Adler, and Chan); and the Sections of Nephrology (Drs Alon and Chan) and Infectious Diseases (Dr Adler), Children's Medical Center, Virginia Commonwealth University, Richmond.

Footnotes
Reprint requests to Box 498, MCV Station, Richmond, VA 23298 (Dr Chan).

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