Human Granulocytic Ehrlichiosis Presenting with Acute Renal Failure and Mimicking Thrombotic Thrombocytopenic Purpura

Abstract

We present the case of an elderly female patient presenting with recurrent acute renal failure, fever, altered mental status, abdominal pain, thrombocytopenia and a small number of fragmented red cells on peripheral smear mimicking recurrent thrombotic thrombocytopenic purpura (TTP). Eventually, however, she was diagnosed to have human granulocytic ehrlichiosis (HGE), and after treatment for HGE her clinical and laboratory abnormalities resolved. Ehrlichiosis mimicking TTP, diagnosed at postmortem examination, has been described in a single prior case. As illustrated in this case, there are potential difficulties in diagnosing HGE after plasma exchange, blood transfusion and immunosuppressive therapy. Ehrlichiosis, a potentially curable disease, should be considered in the differential diagnosis of thrombotic microangiopathic disorders.

Journal

Journal ID (publisher-id): AJN

Journal ID (nlm-ta): Am J Nephrol

Journal ID (doi): 10.1159/issn.0250-8095

Title: American Journal of Nephrology

Publisher: S. Karger AG

ISSN (Print): 0250-8095

ISSN (Electronic): 1421-9670

Publication date Subscription-year: 1999

Publication date (Print): December 1999

Publication date (Electronic): 26 November 1999

Volume: 19

Issue: 6

Pages: 677-681

Affiliations

Divisions of ^aNephrology, ^bInfectious Disease, and ^cHematology, Department of Medicine, Hennepin County Medical Center, Minneapolis, Minn., USA

Article

Publisher ID: 13541 Other ID: Am J Nephrol 1999;19:677–681

DOI: 10.1159/000013541

PubMed ID: 10592363

Copyright statement: © 1999 S. Karger AG, Basel

License:

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Page count

Figures: 2, References: 21, Pages: 5

Product

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Categories

Subject: Case Report