Hemolytic uremic syndrome after bone marrow transplantation without total body irradiation

The cause of hemolytic uremic syndrome after bone marrow transplantation is unknown. Investigators have implicated multiple causes, including cyclosporin A, graft versus host disease, cytomegalovirus infection, and total body irradiation. We report a case of biopsy-supported hemolytic uremic syndrome in a recipient of an autologous bone marrow transplant who did not receive total body irradiation or cyclosporin A and did not have clinical evidence of cytomegalovirus infection. This case casts doubt on the hypothesis that irradiation or any of these factors is the sole and universal cause of hemolytic uremic syndrome in patients receiving bone marrow transplants.