[Uremic hemolytic syndrome in the adult. A study of four cases (author's transl)].

Four cases of the uremic-hemolytic syndrome in the adult are presented. One of them was associated with the presence of the Australia antigen in the plasma. Another had recurrent and familial characteristics associated with the ingestion of oral contraceptives and exhibited a persistent activation of the C3 fraction and the presence of C3NeF (nephritic factor). The two remaining cases were associated with the post partum. Three patients have received sodium heparin continuously, two of which (post partum uremic-hemolytic syndrome) recovered the renal function. A third case, with recurrent uremic-hemolytic syndrome, presented an improvement of the renal function under heparin treatment after the first episode of the disease, but not after the second. Two patients are included in a program of periodic hemodyalisis. The mechanisms by which infections, ingestion of oral contraceptives or post partum can produce an intravascular coagulation syndrome or immunitary disorders are analyzed, both phenomena being interrelated and apparently playing an important role in the pathogenesis of the uremic-hemolytic syndrome.