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. 2025 Mar 10;6(2):193-195.
doi: 10.1002/jpr3.70014. eCollection 2025 May.

Atypical hemolytic uremic syndrome: a rare complication of postendoscopic retrograde cholangiopancreatography pancreatitis

Apoorva Nanagiri  1 , Samantha Pravder  1 , Sonia Solomon  2 , Virender Tewari  3 , Howard Bostwick  1
Affiliations

Atypical hemolytic uremic syndrome: a rare complication of postendoscopic retrograde cholangiopancreatography pancreatitis

Apoorva Nanagiri et al. JPGN Rep. .

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is a crucial procedure for diagnosing and managing conditions affecting the pancreas and biliary tract. The procedure can be technically challenging and carries risks of complications, with post-ERCP pancreatitis (PEP) being the most common. We report a case of a 16-year-old female who presented with cholelithiasis that progressed to choledocholithiasis which was removed using ERCP. Following this, she developed PEP and subsequently progressed to atypical hemolytic uremic syndrome, a rare complication reported in the pediatric literature.

Keywords: Thrombotic microangiopathy; choledocholithiasis; eculizumab; renal impairment.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Left: Fluoroscopic image showing choledocholithiasis (arrow). Right: Occlusion cholangiogram demonstrating bile duct clearance after stone extraction.
Figure 2
Figure 2
ERCP image showing sphincterotomy and extracted gallstone (arrow). ERCP, Endoscopic retrograde cholangiopancreatography.
See this image and copyright information in PMC

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