Recurrence of the hemolytic uremic syndrome in a 3 1/2-year-old child, 4 months after second renal transplantation.

Terminal renal failure secondary to the hemolytic uremic syndrome (HUS) developed 18 months after initial transplantation and 4 1/2 months after the child received his second cadaveric renal allograft. Recurrence of the syndrome was evidenced by gross hematuria and hypertension after a 'flu-like' illness, sudden decrease in platelet count and hemoglobin, and erythrocyte fragmentation. Renal biopsy findings were compatible with HUS. Evidence is presented that the HUS was a recurrence of the original disease.