Shiga toxin-producing Escherichia coli-associated hemolytic uremic syndrome with recurrent acute cholecystitis: a case report.

IF 1 Q4 UROLOGY & NEPHROLOGY
CEN Case Reports Pub Date : 2024-06-01 Epub Date: 2023-11-14 DOI:10.1007/s13730-023-00831-5
Ryuta Uwatoko, Nao Kani, Shuzo Makino, Tomoya Naka, Kazuhiro Okamoto, Hiromitsu Miyakawa, Nobuhiro Hashimoto, Rei Iio, Yoshiyasu Ueda, Terumasa Hayashi
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引用次数: 0

Abstract

Shiga toxin-producing Escherichia coli-associated hemolytic uremic syndrome (STEC-HUS) can induce life-threatening complications, including acute kidney injury, encephalopathy, and gastrointestinal complications. On the other hand, there have been few reports of cholecystitis associated with STEC-HUS. In this study, we report the case of an 83-year-old Japanese man who developed recurrent acute cholecystitis associated with STEC-HUS. Prior to establishing a definite diagnosis of STEC-HUS, plasma exchange and hemodialysis were initiated, which resulted in a rapid increase in the platelet count and decrease in lactate dehydrogenase levels. The patient presented an enlarged gallbladder detected by computed tomography during the course of treatment. Due to recurrent flare-ups, the patient had to undergo several rounds of endoscopic retrograde biliary drainage and, ultimately, cholecystectomy to prevent relapse of acute cholecystitis. Since cholecystitis was thought to have been caused by complex mechanisms in this case, we discussed those from multiple perspectives. This case report highlights the need for particular care to be given to the management of pre-existing diseases as well as STEC-HUS, especially in older patients.

产志贺毒素大肠杆菌相关溶血性尿毒症综合征伴复发性急性胆囊炎1例报告。
产志贺毒素大肠杆菌相关溶血性尿毒症综合征(STEC-HUS)可诱发危及生命的并发症,包括急性肾损伤、脑病和胃肠道并发症。另一方面,很少有胆囊炎与STEC-HUS相关的报道。在这项研究中,我们报告了一例83岁的日本男性,他发展为与STEC-HUS相关的复发性急性胆囊炎。在明确诊断STEC-HUS之前,进行了血浆置换和血液透析,导致血小板计数迅速增加,乳酸脱氢酶水平下降。在治疗过程中,患者通过计算机断层扫描发现胆囊肿大。由于反复发作,患者不得不接受几轮内镜下逆行胆道引流,并最终进行胆囊切除术,以防止急性胆囊炎复发。由于胆囊炎被认为是由复杂的机制引起的,我们从多个角度进行了讨论。本病例报告强调需要特别注意对既存疾病以及stc - hus的管理,特别是对老年患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CEN Case Reports
CEN Case Reports UROLOGY & NEPHROLOGY-
CiteScore
1.90
自引率
0.00%
发文量
80
期刊介绍: Clinical and Experimental Nephrology (CEN) Case Reports is a peer-reviewed online-only journal, officially published biannually by the Japanese Society of Nephrology (JSN).  The journal publishes original case reports in nephrology and related areas.  The purpose of CEN Case Reports is to provide clinicians and researchers with a forum in which to disseminate their personal experience to a wide readership and to review interesting cases encountered by colleagues all over the world, from whom contributions are welcomed.
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