Clinical Features of Hemolytic Uremic Syndrome in Children

Lee, Ju Eun; Kim, Su Yung

Abstract

PURPOSE: Hemolytic uremic syndrome(HUS) is the most common cause of renal failure in childhood in western countries, but it has been a relatively rare disease in Korea. To analyze the clinical and epidemiologic characteristics of HUS in Korea, we reporte our experience,
METHODS
We reviewed retrospectively the medical records of 9 patients who were diagnosed the hemolytic uremic syndrorne at Pusan National University during the period from January 1984 to December 1998.
RESULTS
The age at presentation ranged from 3 years to 12 years old(mean: 5.9 years). Six of the children were typical and three patients were atypical. Six cases had grossly bloody stools and seven had abdominal pain. Oliguria developed in four cases and gross hematuria in eight cases. One case had seizure and letargy. Verotoxin producing E. coli(VTEC) were found in the stool specimens of two pa- tients. One was the serotype 0157:H7 and the other was the serotype 026:H-, Olll:H21. Verotoxin 1 (VT1) genes were identified by PCR in both of the cases. All patients required conservative treatment. Two patients were treated with peritoneal dialysis, one patient with hemodialysis and one patient with plasmapheresis. Of 9 case, 6 recovered without residual sequelae, but two patients died, and one patient progressed to end stage renal failure.
CONCLUSION
Two thirds of our cases were typical type of HUS, which is now the predominant type among Korean childhood HUS sufferers. From this study, we suggest that patients diagnosed with typical HUS should be studied for the verotoxin of E. coli isolated from stool.