Incidentally detected bilateral sub-internal limiting membrane hemorrhages in typical hemolytic uremic syndrome: a case report
We present an incidentally detected case of bilateral sub-internal limiting membrane (ILM) hemorrhage secondary to typical hemolytic uremic syndrome (HUS) along with a literature review. A 4-year-old girl presented to our emergency department with bloody diarrhea, abdominal pain, fever, and oliguria...
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Korean Society of Pediatric Nephrology
2025-02-01
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| Series: | Childhood Kidney Diseases |
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| Online Access: | http://chikd.org/upload/ckd-25-003.pdf |
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| author | Han Jo Kwon Ji Yeon Song |
| author_facet | Han Jo Kwon Ji Yeon Song |
| author_sort | Han Jo Kwon |
| collection | DOAJ |
| description | We present an incidentally detected case of bilateral sub-internal limiting membrane (ILM) hemorrhage secondary to typical hemolytic uremic syndrome (HUS) along with a literature review. A 4-year-old girl presented to our emergency department with bloody diarrhea, abdominal pain, fever, and oliguria. HUS was suspected based on clinical symptoms and laboratory findings suggestive of hemolytic anemia, thrombocytopenia, and acute kidney injury. Supportive management, including intermittent dialysis, was provided during admission. However, the patient exhibited central nervous system involvement and presented with a seizure. Despite the absence of visual symptoms, a fundus examination revealed unexpected bilateral sub-ILM hemorrhages and a cotton wool spot in the right eye. Blood dyscrasia improved with repeated hemodialysis and red blood cell transfusions. The sub-ILM hemorrhage gradually resolved, as observed on consecutive fundus photographs. Multimodal retinal imaging revealed healthy capillary structures without evidence of macular ischemia or fibrosis. Typical HUS can be accompanied by a sub-ILM hemorrhage without preceding symptoms. The absence of visual symptoms, despite significant retinal abnormalities, emphasizes the importance of immediate and routine fundus examinations in patients with typical HUS. This proactive approach improves early detection of ocular involvement, enabling prompt intervention to manage potential visual complications, and ultimately improving patient outcomes. |
| format | Article |
| id | doaj-art-ee675d2a2cfc47188b7e68c776eaa5ca |
| institution | OA Journals |
| issn | 2384-0242 2384-0250 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Korean Society of Pediatric Nephrology |
| record_format | Article |
| series | Childhood Kidney Diseases |
| spelling | doaj-art-ee675d2a2cfc47188b7e68c776eaa5ca2025-08-20T02:24:33ZengKorean Society of Pediatric NephrologyChildhood Kidney Diseases2384-02422384-02502025-02-01291323810.3339/ckd.25.003822Incidentally detected bilateral sub-internal limiting membrane hemorrhages in typical hemolytic uremic syndrome: a case reportHan Jo Kwon0Ji Yeon Song1 Department of Ophthalmology, Pusan National University Hospital, Busan, Republic of Korea Department of Pediatrics, Pusan National University Children’s Hospital, Pusan National University School of Medicine, Yangsan, Republic of KoreaWe present an incidentally detected case of bilateral sub-internal limiting membrane (ILM) hemorrhage secondary to typical hemolytic uremic syndrome (HUS) along with a literature review. A 4-year-old girl presented to our emergency department with bloody diarrhea, abdominal pain, fever, and oliguria. HUS was suspected based on clinical symptoms and laboratory findings suggestive of hemolytic anemia, thrombocytopenia, and acute kidney injury. Supportive management, including intermittent dialysis, was provided during admission. However, the patient exhibited central nervous system involvement and presented with a seizure. Despite the absence of visual symptoms, a fundus examination revealed unexpected bilateral sub-ILM hemorrhages and a cotton wool spot in the right eye. Blood dyscrasia improved with repeated hemodialysis and red blood cell transfusions. The sub-ILM hemorrhage gradually resolved, as observed on consecutive fundus photographs. Multimodal retinal imaging revealed healthy capillary structures without evidence of macular ischemia or fibrosis. Typical HUS can be accompanied by a sub-ILM hemorrhage without preceding symptoms. The absence of visual symptoms, despite significant retinal abnormalities, emphasizes the importance of immediate and routine fundus examinations in patients with typical HUS. This proactive approach improves early detection of ocular involvement, enabling prompt intervention to manage potential visual complications, and ultimately improving patient outcomes.http://chikd.org/upload/ckd-25-003.pdfcase reportshemolytic-uremic syndromepediatricsretinal hemorrhage |
| spellingShingle | Han Jo Kwon Ji Yeon Song Incidentally detected bilateral sub-internal limiting membrane hemorrhages in typical hemolytic uremic syndrome: a case report Childhood Kidney Diseases case reports hemolytic-uremic syndrome pediatrics retinal hemorrhage |
| title | Incidentally detected bilateral sub-internal limiting membrane hemorrhages in typical hemolytic uremic syndrome: a case report |
| title_full | Incidentally detected bilateral sub-internal limiting membrane hemorrhages in typical hemolytic uremic syndrome: a case report |
| title_fullStr | Incidentally detected bilateral sub-internal limiting membrane hemorrhages in typical hemolytic uremic syndrome: a case report |
| title_full_unstemmed | Incidentally detected bilateral sub-internal limiting membrane hemorrhages in typical hemolytic uremic syndrome: a case report |
| title_short | Incidentally detected bilateral sub-internal limiting membrane hemorrhages in typical hemolytic uremic syndrome: a case report |
| title_sort | incidentally detected bilateral sub internal limiting membrane hemorrhages in typical hemolytic uremic syndrome a case report |
| topic | case reports hemolytic-uremic syndrome pediatrics retinal hemorrhage |
| url | http://chikd.org/upload/ckd-25-003.pdf |
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