• Sandesh Gaire, Mandira Shrestha, Chaitanya Darshan Bhattarai, Susajjan Dhungana, Surakshya Gyawali, and Arun Bajgain.
• Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal.
• JNMA J Nepal Med Assoc. 2023 May 1; 61 (261): 472474472-474.

UnlabelledThrombotic microangiopathy is a pathological condition comprised of microvascular thrombosis involving any body organ leading to thrombocytopenia, coombs-negative hemolytic anemia, and end-organ damage. The clinical presentation of the case shows typical hemolytic uremic syndrome, however, lab reports show atypical hemolytic uremic syndrome (low C3). Pain abdomen and loose stool with some signs of dehydration were initial presentations. Early initiation of renal replacement therapy and management of dehydration was done. Simple diarrhea can also manifest as acute kidney injury with the hemolytic uremic syndrome. Hence we should keep hemolytic uremic syndrome as the differential diagnosis of diarrhea. Irrespective of lab parameters, early management in line with the typical hemolytic uremic syndrome should be done for better outcomes.Keywordsanemia; case reports; dehydration; renal replacement therapy.

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