[A case of hemolytic uremic syndrome associated with circulating anticoagulant]

A previously well 66-year-old woman was admitted to our hospital because of severe abdominal pain, oliguria, jaundice and hemoglobinuria. At admission, the following values were obtained: red blood cell count 261 x 10(4)/mm3, serum creatinine 2.8mg/100ml, total bilirubin 8.0mg/ml, indirect bilirubin 5.7mg/100ml, LDH 13886 WU, negative direct and indirect Coomb's test and peripheral blood smear showing schistocytosis. She was diagnosed as hemolytic uremic syndrome and was successfully treated with plasma infusion, plasma exchange and hemodialysis. The results of the tests for verotoxin titer of E. coli O157: H7 and circulating anticoagulant were positive. The test result for anticoagulant eventually became negative during her clinical course. In this case, circulating anticoagulant might have contributed to the pathogenesis of hemolytic uremic syndrome.