Document 1149
 DOCN  M94A1149
 TI    Hemolytic uremic syndrome in patients with HIV infection.
 DT    9412
 AU    Blanche P; Bachmeyer C; Sereni D; Salmon D; Boissonnas A; Dreyfus F;
       Sicard D; Departement de Medecine Interne, Hopital Cochin, Paris,;
       France.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):198 (abstract no. PB0804). Unique
       Identifier : AIDSLINE ICA10/94371426
 AB    OBJECTIVE: To determine clinical, laboratory features and outcome of
       hemolytic-uremic syndrome (HUS) in patients with HIV infection. METHODS:
       From November 1991 to December 1993, 9 HIV-patients among 1423 (0.6%)
       attending our institution experienced HUS. The diagnosis relied on
       microangiopathic hemolytic anemia, thrombocytopenia, and renal failure.
       RESULTS: The mean age was of 47 years (30.65), mean time from
       seropositivity was 4.6 years (0.9). Pts were homosexual (n = 6),
       heterosexual (n = 1), blood recipient (n = 1), IV drug user (n = 1).
       Eight pts belonged to group IV of CDC at the time of diagnosis.
       Neurological signs including confusion and seizures were observed in 6
       pts. Mean hemoglobin was 7.0 g/dl (5.7-8) with schizocytes (n = 9),
       platelet count 30.8 x 10(9)/l (8.0-67.0), serum creatinine 330 pmol/l
       (131-770). Cryptosporidiosis (n = 2) and bleomycine treatment (n = 1)
       were considered as precipitating events. Treatment consisted of steroids
       (n = 5), fresh frozen plasma infusions (n = 4), acetylsalicylic acid (n
       = 4), IV gammaglobulins (n = 3), plasma exchange (n = 3), dipyridamole
       (n = 2), splenectomy (n = 1). Seven pts died of HUS with or without
       sepsis within 3 months, one died of sepsis 1 year later after recovering
       of HUS. One was still alive and recovering 3 months later. DISCUSSION
       AND CONCLUSIONS: HUS can occur in the course of the HIV infection or
       indicate it. The role of HIV can be suggested in its genesis, but other
       precipitating factors such as infectious agents or drugs can be
       involved. Clinicians must be aware of risk of HUS in HIV-infected pts
       and initiate aggressive treatment, since HUS is associated with poor
       prognosis.
 DE    Hemolytic-Uremic Syndrome/*COMPLICATIONS  Human  HIV
       Infections/*COMPLICATIONS  Middle Age  MEETING ABSTRACT

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