We report our experience in the acute management of a seven-year-old child with severe hemolytic uremic syndrome. On three separate occasions, acute neurologic signs dramatically resolved during simultaneous exchange transfu sion and hemodialysis. The ease with which exchange transfusion may be combined with acute hemodialysis is discussed. In selected cases of hemolytic uremic syndrome with marked neurologic manifestations, exchange trans fusion may offer a benefit similar to that reported in adults with thrombotic thrombocytopenic purpura.
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