Reference no: EM133707285

Question

Ryan, a 6 year-old male, was present in the emergency room with a four-day history of bloody diarrhea, thrombocytopenia, anemia, and elevated BUN and creatinine. On admission, significant laboratory findings include: Hb 10.5 g/dL Hct 31.6 % Platelets 45 × 109/L BUN 43 mg/dL Creatinine 2.46 mg/dL Lactate dehydrogenase 5455 U/L A stool culture was performed, and the isolate was identified as 'STEC' Over the course of the two days his BUN and creatinine increased and he was started on hemodialysis on Day 3. His BUN and creatinine continued to rise over this time (peak of 102 mg/dL and 7.36 mg/dL, respectively), and with worsening of his clinical picture, he was placed on continuous renal replacement therapy. On Day 5, he was started on the treatment protocol with Solaris® (eculizumab). His BUN and creatinine gradually improved and were 24 mg/dL and 0.94 mg/dL, respectively, by discharge. Both BUN and creatinine were within normal limits on recheck 4 days after discharge at 13 mg/dL and 0.61 mg/dL, respectively.

1. Review the data presented and provide a presumptive diagnosis for this patient.

2. What are the abnormal laboratory results and how do those, along with the clinical signs and symptoms and patient.