Adrenal hyperechogenicity in hemolytic uremic syndrome

Hemolytic uremic syndrome is characterized by an abrupt onset of a microangiopathy, thrombocytopenia, hemolytic anemia and renal failure. These abnormalities present in varying degrees. The vascular abnormalities include endothelial swelling and thrombus formation. The kidney is the major target of involvement, although intestines, lung and brain may also be affected. It is considered a disease of the infant, although it occurs in older children and adults as a component of thrombotic thrombocytopenic purpura. We present the sonographic findings of adrenal involvement in a child with hemolytic uremic syndrome, which seems to be a rare occurrence. The patient developed adrenal insufficiency during the acute phase of the disease.