In adults, the diagnosis and the clinical management of atypical hemolytic uremic syndrome is still a challenge for hematologists. Here, we report a case of a 40-year-old previously healthy man presented to the emergency department with fever (39.6◦C) and bilateral persistent foot pain. He has been 2 days earlier by his primary care doctor due to lower extremities pain and a sensation of low body temperature during physical activity. At admission, he was found diaphoretic, apyretic (reported paracetamol intake at home), tachycardic, with marbled lower limbs and lack of sensitivity in both feet. The patient’s history was negative for recurrent infections, kidney diseases, immune-rheumatological, or cardiovascular disorders. He smoked 20 cigarettes/day.
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