Document 0294
 DOCN  M9590294
 TI    Hemolytic uremic syndrome and thrombotic thrombocytopenic purpura in
       patients with HIV infection.
 DT    9509
 AU    Harangozo CS; Marshall C; Slavin M; Fairfield Hospital, Victoria.
 SO    Annu Conf Australas Soc HIV Med. 1994 Nov 3-6;6:214 (unnumbered
       abstract). Unique Identifier : AIDSLINE ASHM6/95291805
 AB    Hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura
       (TTP) have recently been described in association with HIV infection. We
       report 2 cases of HUS and 1 case of TTP associated with HIV. All 3
       patients had advanced HIV disease with CD4 counts of 30 or less. 2
       patients displayed the classical triad of features of HUS, namely
       anemia, thrombocytopenia and renal failure, with renal biopsy in both
       showing severe thrombotic microangiopathy. The 3rd patient had the above
       features and in addition had fever and progressive neurological deficit
       consistent with TTP. 1 patient with HUS responded to combination therapy
       including plasma exchange; the other 2 patients did not receive plasma
       exchange and had fatal outcomes. HUS/TTP in HIV patients presents with
       similar clinical features to that in non-HIV. 50% of reported cases have
       occurred in patients prior to development of AIDS. Most reported HIV
       patients have had mild renal impairment and features of TTP rather than
       HUS. Short term response to conventional therapy including plasma
       exchange has been comparable to that in non-HIV patients, but long term
       outcome is not clear. Anemia, thromboctopenia and neurological
       abnormalities are each common in HIV disease, severe renal dysfunction
       less so. Although rare, recognition of HUS/TTP is important as treatment
       is usually effective.
 DE    Biopsy  Combined Modality Therapy  Diagnosis, Differential
       Hemolytic-Uremic Syndrome/*DIAGNOSIS/THERAPY  Human  HIV
       Infections/*DIAGNOSIS/THERAPY  Kidney/PATHOLOGY  Kidney Function Tests
       Plasma Exchange  Purpura, Thrombotic Thrombocytopenic/*DIAGNOSIS/THERAPY
       MEETING ABSTRACT

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