Hemolytic Uremic Syndrome and SARS-CoV-2 Infection: A Rare Association

Abstract

Thrombotic microangiopathies (TMA) are rare diseases,
with high morbimortality. Among them, atypical hemolytic uremic syndrome (HUS), associated with deregulation of alternative complement pathway (genetic/acquired), represents a diagnostic challenge. Characterized by thrombotic microangiopathy, acute renal failure is one of its main features. Etiological/ precipitant detection (TMA triggers) is essential, even though about 30% of cases remain idiopathic. There is not a direct diagnostic test, which makes this an exclusion final diagnosis (after primary and secondary causes are ruled-out). Further testing
for genetic variations is important for prognostic purposes.

We describe the case of a 40 years old woman, whose
final diagnostic was an atypical HUS associated with SARS-
-CoV-2 infection. This case stands out by its rarity.

We underline the importance of prompt initial diagnosis and timely target treatment beginning: Eculizumab, the only one available in Portugal at the moment. Plasmapheresis and/or
renal replacement therapy must be considered case by case.