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Case Report

Enterococcus raffinosus Infection with Atypical Hemolytic Uremic Syndrome in a Multiple Myeloma Patient after Autologous Stem Cell Transplant

by
Pankaj Mathur
1,*,
Blake Hollowoa
2,
Nupur Lala
2,
Sharmilan Thanendrarajan
1,
Aasiya Matin
1,
Atul Kothari
1 and
Carolina Schinke
1
1
Myeloma Institute, University of Arkansas Medical Sciences, Medical Center, Slot 816, Little Rock, AR 72205, USA
2
MS4, University of Arkansas Medical Sciences, Little Rock, AR 72205, USA
*
Author to whom correspondence should be addressed.
Hematol. Rep. 2017, 9(3), 7094; https://doi.org/10.4081/hr.2017.7094
Submission received: 15 February 2017 / Revised: 18 August 2017 / Accepted: 18 August 2017 / Published: 26 September 2017

Abstract

Autologous hematopoietic stem cell transplant (AHSCT) is the standard of care in the treatment of multiple myeloma worldwide. Infections are one of the most common complications of the chemotherapy regimen and AHSCT. Thrombotic microangiopathies are one of the rare but potentially life-threatening complications of infections associated with AHSCT. Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome (HUS) are two most common type of thrombotic microangiopathies. The HUS is classically related to diarrheal illness such as with E. coli strain O157: H7 that produce Shiga-like toxins. But it has never been described with Enterococcus raffinosus urinary tract infections (UTI). Here we are describing a case of atypical HUS associated with Enterococcus raffinosus UTI in a patient with multiple myeloma after AHSCT. The management of atypical HUS especially after AHSCT is challenging. Eculizumab, a humanized monoclonal antibody against complement protein C5, and thrombomodulin have emerging role in the management of some cases, but more studies are needed to define evidence-based management of this condition.
Keywords: multiple myeloma; autologous stem cell transplant; transplant associated microangiopathy multiple myeloma; autologous stem cell transplant; transplant associated microangiopathy

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MDPI and ACS Style

Mathur, P.; Hollowoa, B.; Lala, N.; Thanendrarajan, S.; Matin, A.; Kothari, A.; Schinke, C. Enterococcus raffinosus Infection with Atypical Hemolytic Uremic Syndrome in a Multiple Myeloma Patient after Autologous Stem Cell Transplant. Hematol. Rep. 2017, 9, 7094. https://doi.org/10.4081/hr.2017.7094

AMA Style

Mathur P, Hollowoa B, Lala N, Thanendrarajan S, Matin A, Kothari A, Schinke C. Enterococcus raffinosus Infection with Atypical Hemolytic Uremic Syndrome in a Multiple Myeloma Patient after Autologous Stem Cell Transplant. Hematology Reports. 2017; 9(3):7094. https://doi.org/10.4081/hr.2017.7094

Chicago/Turabian Style

Mathur, Pankaj, Blake Hollowoa, Nupur Lala, Sharmilan Thanendrarajan, Aasiya Matin, Atul Kothari, and Carolina Schinke. 2017. "Enterococcus raffinosus Infection with Atypical Hemolytic Uremic Syndrome in a Multiple Myeloma Patient after Autologous Stem Cell Transplant" Hematology Reports 9, no. 3: 7094. https://doi.org/10.4081/hr.2017.7094

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