ArticleCureus2025
A Rare Case of Atypical Haemolytic Syndrome Following Right Retrograde Intrarenal Surgery (RIRS).
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Renal failure, non-immune hemolytic anemia, and thrombocytopenia are the hallmarks of the uncommon but potentially fatal complement system-related illness known as atypical hemolytic uraemic syndrome (aHUS). We describe the case of a 46-year-old woman who underwent right retrograde intrarenal surgery (RIRS) for a 1.5 cm urinary stone in the renal pelvis and experienced septic shock on postoperative day 1 caused by aHUS. The patient received continuous venovenous hemodiafiltration (CVVHDF) for six days, eculizumab, a monoclonal antibody that blocks terminal complement activation, and three plasma exchanges with fresh frozen plasma, resulting in a progressive normalization of hemolytic parameters. Two months after the RIRS, the patient underwent percutaneous nephrolithotripsy to remove residual kidney stones. Three days before the surgery, she received a dose of eculizumab. The procedure went smoothly, and there were no postoperative complications. To the best of our knowledge, this is the report that mentions aHUS as a postoperative complication following endourology procedures. This report focuses on multidisciplinary diagnosis, treatment, and follow-up strategies for this unique complication in urology.
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