Supplementary Material for: Campylobacter colitis as a trigger for atypical hemolytic uremic syndrome: about one case

Hemolytic uremic syndrome (HUS) belongs to the family of thrombotic microangiopathies (TMA). The diagnosis of HUS is suggested by the following triad: mechanical hemolytic anemia, thrombocytopenia and acute renal failure. In general, two types of HUS are distinguished: typical HUS, usually caused by Shiga toxin–producing Escherichia coli (STEC), and atypical HUS (aHUS) caused by deregulated complement activation. Here we present the case of a 17-year-old adolescent with factor H-associated aHUS, whose initial presentation was that of a typical diarrhea-associated HUS. The purpose of this article is to draw attention to this peculiar onset of an authentic aHUS and to stress the importance of analysing the alternate pathway of complement if the course of a supposedly typical HUS turns out to be unusual.

溶血性尿毒症综合征（hemolytic uremic syndrome, HUS）隶属于血栓性微血管病（thrombotic microangiopathies, TMA）家族。HUS的临床诊断依据下述三联征：机械性溶血性贫血、血小板减少症与急性肾衰竭。目前普遍将HUS分为两类：一类为典型HUS，多由产志贺毒素大肠埃希菌（Shiga toxin–producing Escherichia coli, STEC）感染引发；另一类为非典型HUS（atypical HUS, aHUS），其病因与补体激活失调相关。本文报告1例17岁青少年罹患因子H相关性非典型溶血性尿毒症综合征的病例，该患者初始临床表现符合典型腹泻相关性HUS的特征。本文旨在提请临床关注此种以典型HUS样起病的真性非典型HUS特殊表现，并强调若疑似典型HUS患者的病程表现异于常规，需重视补体旁路途径的相关检测分析。