# Hemolytic uremic syndrome in severe acute pancreatitis

## TL;DR

A rare case of hemolytic uremic syndrome occurred in a patient with severe acute pancreatitis, leading to a fatal outcome despite aggressive treatment.

## Contribution

This case report highlights hemolytic uremic syndrome as an atypical and severe complication of acute pancreatitis.

## Key findings

- Hemolytic uremic syndrome was diagnosed in a 36-year-old male with acute pancreatitis.
- The patient had low C3, normal C4, and positive anti-complement factor H antibody.
- Despite plasmapheresis, hemodialysis, and immunoglobulin therapy, the patient succumbed to the illness.

## Abstract

Introduction: Hemolytic Uremic Syndrome is characterized by Coombs negative microangiopathic hemolytic anemia, severe thrombocytopenia, and acute kidney injury.

Case Report: Here, we report a 36-year-old male, a case of alcohol related acute pancreatitis. On day 5, he developed fever and tachycardia. Evaluation revealed thrombocytopenia, hemolytic anemia, and acute kidney injury with low C3, normal C4 & ADAMTS13 activity and positive anti-complement factor H antibody. He was diagnosed as a case of Hemolytic Uremic Syndrome and managed with plasmapheresis, hemodialysis, and Intravenous immunoglobulin. He was administered Rituximab on day 15, considering the refractory nature of the disease. Despite the aggressive management, he succumbed to his illness.

Conclusion: This case highlights atypical Hemolytic Uremic Syndrome as a rare complication of Acute Pancreatitis. Our patient, despite being diagnosed well in time and managed aggressively, had an unfavourable outcome. This condition should be diagnosed well in time, as it is associated with high mortality.