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Background:AtypicalHaemolyticUremicSyndrome(aHUS)isararelifethreateningentitycharacterizedbythrombocytopenia,haemolyticanaemiaandrenaldysfunction.Itisathromboticmicroangiopathyrelatedtogeneticmutationsinthealternatecomplementpathwayandhasadistinctpathophysiologywhichmakesithardertodistinguishfromothermicroangiopathies.Wepresentacaseofa25-year-oldmalepatientwithhistoryofpolysubstanceabusewhopresentedwithchestpainanddyspnoea.Headmittedtousinginjectableoxymorphone(Opana)twoweeksbeforepresentation.Patient’svitalsignswerestableexceptfortachycardiaandhighbloodpressure.Onphysicalexamination,epigastrictendernessandmildsplenomegalywasappreciated.UrineDrugScreenwaspositiveforoxycodoneandopiates.Laboratoryworkuprevealedhaemolyticanaemia,thrombocytopeniaandacutekidneyinjury.Extensiveevaluationresultedinourimpressionofthediseasebeingatypicalhaemolytic-uremicsyndrome.Hewasmanagedwithdialysis,intravenoussteroidsandplasmapheresiswithimprovementinhishematologicparameters.
AmibhenGandhi,, SaadUllah,, ShaniKotadia, ,SamerNasser. (2017) OXYMORPHONEINDUCEDTHROMBOTICMICROANGIOPATHYMIMICKINGATYPICALHAEMOLYTICUREMICSYNDROME, , Volume 29, Issue 2.
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