Authors
Han Jo Kwon, Ji Yeon Song
Published in
Childhood kidney diseases. Volume 29. Issue 1. Pages 32-38. Epub Feb 28, 2025.
Abstract
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.
PMID:
42779581
Bibliographic data and abstract were imported from PubMed on 24 Sep 2026.
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