Hemolytic Uremic Syndrome

Viteri, Bernarda; Saland, Jeffrey M.

doi:10.1542/pir.2018-0346

Cited by 12 publications

(9 citation statements)

References 4 publications

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“…In the pathogenesis of HUS, primary damage to the vascular endothelium is responsible for the occurrence of the triad of microangiopathic hemolytic anemia, thrombocytopenia, and AKI. Pediatric HUS cases are mostly classified as typical HUS with the old definition, which is classically caused by STEC and constitutes 90% of cases, and atypical HUS cases, which are usually caused by abnormalities in the inherited alternative complement pathway [1]. The patients with STEC HUS typically develop AKI within 2–12 days after the onset of bloody diarrhea [7].…”

Section: Discussionmentioning

confidence: 99%

“…Diarrhea-associated hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy (TMA) characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury (AKI), usually followed by bloody diarrhea caused by Shiga toxin-producing Escherichia coli (STEC) [1]. However, different agents that cause diarrhea can also cause TMA in the organism.…”

Section: Introductionmentioning

confidence: 99%

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Hemolytic Uremic Syndrome Associated with Norovirus Gastroenteritis: Case Report and Literature Review

Yılmaz

Yüksel

2022

Nephron

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A previously healthy 3-year-old girl was admitted with fever, nonbloody diarrhea, vomiting for 3 days, and oliguria. Physical examination showed fatigue, pale appearance, hypertension, and mild periorbital edema. Laboratory examinations revealed anemia, thrombocytopenia, acute kidney injury, high LDH, and low haptoglobin levels. Urinalysis showed proteinuria and hematuria. Schistocytes and helmet cells were detected in the peripheral blood smear. There were no electrolyte imbalance and hypocomplementemia. Direct Coombs and viral panel were negative. Blood, urine, throat, and stool cultures were negative. Norovirus GII was positive in stool PCR, while other diarrheal agents were negative. The patient was diagnosed with norovirus gastroenteritis-induced hemolytic uremic syndrome (HUS). Furosemide was started for oliguria and hypertension, and blood pressure was controlled with oral nifedipine. On the 12th day of hospitalization, he was discharged with fully recover. To date, norovirus-associated HUS has been reported in 5 cases. Two of these are adult cases and the other three and our case are pediatric patients. In this case report and literature review, we observed that norovirus can cause HUS, especially in children, with a milder course than other types of HUS. The reason why it is more complicated in adult cases may be the presence of an additional underlying kidney disease. Since it was detected coincidentally in 1 case in the literature, it may be useful to screen for mutations in the complement pathway that may cause aHUS, if possible, in diarrhea-associated HUS caused by norovirus agents, but it was not present in our case.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hemolytic Uremic Syndrome Associated with Norovirus Gastroenteritis: Case Report and Literature Review

Yılmaz

Yüksel

2022

Nephron

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“…The complete triad of HUS is defined as hemolytic anemia characterized by a hemoglobin (Hb) level <10 g/dL, detection of schistocytes in peripheral blood smear with a negative Coombs test confirming microangiopathic hemolysis, thrombocytopenia with a platelet count < 150 x109/L, and the presence of acute renal failure. Patients with aHUS such as inherited forms of HUS and HUS secondary to organisms other than STEC were excluded (1,2).…”

Section: Maternity and Children's Health And Diseases Training Andmentioning

confidence: 99%

“…Hemolytic-uremic syndrome induced by Shigatoxin-producing Escherichia coli (STEC) is the most common type of the disease and ordinarily has a good prognosis, but aHUS is rare that has a poor prognosis with a relapsing course. Extrarenal manifestations may be occured in 25-30% of cases, including neurological, gastroenterological, cardiac and endocrine involvement (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Clinical Features and Renal Replacement Therapy in Children with Typical Hemolytic Uremic Syndrome

Güngör¹,

Karakaya²,

Çakıcı³

et al. 2022

Turkish Journal of Pediatric Disease

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Objective: A subset of typical Hemolytic-uremic syndrome (HUS) patients requires initiation of renal replacement therapy (RRT) despite aggressive medical intervention. This study aims to evaluate the clinical and laboratory findings of patients diagnosed with typical HUS and efficacy and safety of peritoneal dialysis (PD) and hemodialysis (HD) were compared in managing these cases.Material and Methods: Patients having a diagnosis of typical HUS were retrospectively determined, and assessment the effects of RRT modalities on renal survival. Results:The present study included 49 children with typical HUS, and the mean age was 2.99 ± 1.88 years. Neurological involvement was detected in 15 (30.6%) patients. The neutrophil/lymphocyte ratio (NLR) was significantly higher in the neurological involvement group [odds ratio (OR) 15.42, 95% CI (3.39-70.1), p = 0.005]. In total, 43 (87.7%) patients received RRT and the median time from the first recorded symptom to RRT was six days (range 3-11). While throughout RRT, 10.2% of patients required mechanical ventilation. In this study, 26 (53.1%) patients were managed with PD, and 17 (34.6%) patients were managed with HD. During follow-up, 10.2% of all patients progressed to chronic kidney disease (CKD), proteinuria was detected in 6.1% and hypertension in 4.08%. The risk of CKD was significantly lower in the 3-month period in PD patients than in HD patients (odds ratio (OR) 7.69, 95% CI (0.77-76.07), p = 0.04). Conclusion:We concluded that PD might be as effective and safer as HD concerning kidney recovery. Clinical features and inflammatory markers can predict neurological involvement in typical HUS cases.

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Thrombotische Mikroangiopathien

Schmidt

Huber

2023

Med Klin Intensivmed Notfmed

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Hemolytic Uremic Syndrome

Cited by 12 publications

References 4 publications

Hemolytic Uremic Syndrome Associated with Norovirus Gastroenteritis: Case Report and Literature Review

Hemolytic Uremic Syndrome Associated with Norovirus Gastroenteritis: Case Report and Literature Review

Evaluation of Clinical Features and Renal Replacement Therapy in Children with Typical Hemolytic Uremic Syndrome

Thrombotische Mikroangiopathien

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