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He was admitted to the hospital for alcoholic ketoacidosis, alcohol withdrawal and possible upper gastrointestinal bleed, but ultimately, he developed severe thrombocytopaenia, hemolytic anaemia, acute renal failure and prolonged altered mentation. Given that ST-HUS is uncommon in adults, his initial report of diarrhoea was attributed to alcohol use or underlying active ulcerative colitis and not connected to his haematologic abnormalities. He was initially started on plasmapheresis; however, thrombotic microangiopathy work up revealed Shiga-toxin in his stool and ADAMST13 levels within normal limits. Subsequently, he was transitioned to supportive care for management of ST-HUS.<\/jats:p>","DOI":"10.1136\/bcr-2021-244115","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T14:11:03Z","timestamp":1629382263000},"page":"e244115","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Adult Shigatoxin-mediated hemolytic uremic syndrome masked by alcohol use and inflammatory bowel disease"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4553-6146","authenticated-orcid":false,"given":"Rachel","family":"Thompson","sequence":"first","affiliation":[{"name":"Medical School, University of Minnesota - Twin Cities, Minneapolis, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Peng","sequence":"additional","affiliation":[{"name":"Graduate Medical Education, Abbott Northwestern Hospital, Minneapolis, Minnesota, 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