The pediatric patients with diarrhea associated hemolytic uremic syndrome; increase of regional frequency and clinical outcomes Diyare ilişkili hemolitik üremik sendromlu çocuk hastalarımız; bölgesel sıklık artışı ve klinik sonuçları

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Girişgen İ., YÜKSEL S.

Pamukkale Medical Journal, vol.12, no.3, pp.485-495, 2019 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 12 Issue: 3
  • Publication Date: 2019
  • Doi Number: 10.31362/patd.601262
  • Journal Name: Pamukkale Medical Journal
  • Journal Indexes: Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.485-495
  • Keywords: children, Hemolytic uremic syndrome
  • Çanakkale Onsekiz Mart University Affiliated: No


Purpose: The hemolytic uremic syndrome is characterized by the triad of acute kidney injury, microangiopathic hemolytic anemia, and thrombocytopenia. Shiga toxin producing E. Coli (STEC) the most common cause of hemolytic uremic syndrome in children. The local outbreak of STEC gastroenteritis results in an increased frequency of STEC related HUS. We observed that the frequency of STEC related HUS increased in 2018. The aim of this study is to present the clinical features and treatment of the patients with HUS and compare with that of other HUS outbreaks. Materials and methods: We investigated retrospectively the data of 10 children diagnosed with diarrhea associated hemolytic uremic syndrome in 2018 in our clinic. Demographic data, first admission findings and laboratory examinations, final evaluation and laboratory findings of the patients were recorded. Results: The median age of patients was 17 (10-108) months and four were girls, six were boys. The time of admission the patients was not seasonal. Six patients were suspected of eating the meat which was not cooked enough. It was determined shiga toxin or verotoxin producing E. Coli in five patients. Six patients required dialysis. Eculizumab was used in four cases because of neurological complications and severe HUS symptoms. Seven out of ten patients have fully recovered, and three have been receiving ACE (angiotensin converting enzyme) inhibitors for proteinuria. Conclusion: In our study, 10 patients with diarrhea associated hemolytic uremic syndrome were treated successfully. We think that early renal replacement therapy is effective in the prognosis of the disease. We observed that persistent proteinuria may develop as a complication in patients who suffered from anuria as complaint in first admission. In addition, eculizumab may be a successful option in patients with neurological involvement and selected severe HUS symptoms.