The present report concerns a man with renal cortical necrosis. There was no apparent precipitating causative agent in this case. The renal pathologic findings of intravascular necrosis, occurring concommitant with an acute hemolytic anemia, characterized by the presence of the fragmented red blood cells of microangiopathic hemolytic anemia in the peripheral blood are similar to changes seen in children in the hemolytic-uremic syndrome (HUS).1-8 An increasing number of adult patients with bilateral renal cortical necrosis associated with microangiopathic hemolytic anemia (so-called HUS of adults) are now being reported9-16; however, most reports concern patients with predisposing diseases, such as obstetric complications.
The patient is a 55-year-old black man who was admitted to the Boston City Hospital Fifth Surgical Service (Harvard) Jan 21,1970, with a four-day history of nausea, vomiting, malaise, general weakness, and anuria. No urine was obtained on urethral catheterization. His admission blood urea nitrogen (BUN)