Science and Education Publishing American Journal of Medical Case Reports 2374-216X 3 9 2015 07 28 A Case Report of Atypical Hemolytic Uremic Syndrome Presenting with Massive Proteinuria 278 281 EN Rabia Akhtar Diane Triolo Division of Nephrology, Department of Internal Medicine, St. Joseph's Regional Medical Center AJMCR2015394 10.12691/ajmcr-3-9-4 2015 07 08 2015 07 20 2015 07 28 Atypical hemolytic uremic syndrome (HUS) is most commonly due to dysregulation of the alternative complement pathway. It is characterized by the classic triad of hemolytic anemia, thrombocytopenia, and acute kidney injury. Treatment includes supportive care including hemodialysis along with steroids, plasmapheresis, and eculizumab. We report a case of a 22 year old female who was diagnosed with atypical HUS and was also noted to have a severe degree of proteinuria, nearly 24 grams in the 24 hour urine collection. Proteinuria is observed in cases of atypical HUS because of the glomerular leakage of protein due to severe endothelial and epithelial injury. However, there is little data directly addressing the degree of proteinuria observed in these patients. This leads us to ask whether the degree of proteinuria has any prognostic significance or impact on disease progression and recovery.