ANNUAL INCIDENCE AND CLINICO-LABORATORY STUDY OF HEMOLYTIC UREMIC SYNDROME AMONG ATTENDANTS OF PEDIATRIC ZAGAZIG UNIVERSITY HOSPITAL

Abstract

Background: Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in young children. It is characterized by microangiopathic hemolytic anemia (MAHA), acute renal failure, and thrombocytopenia.
Objective: This work aims to study causes, clinical presentation, annual incidence, and outcome of hemolytic uremic syndrome in children admitted to Pediatric Zagazig University Hospital.
Subjects and methods: This is a descriptive study, carried out at Children hospital, faculty of medicine, Zagazig University during the period from January 2012 to January 2014.This study included 42 patients younger than 15 years with diagnosis of hemolytic uremic syndrome.
Results: Most of cases were younger than 2 years of age (57%). Males (74%) were more affected than females (26%) and most of patients were detected during summer. The overall incidence in pediatric age group ( <15 years) was 1.2 per 100,000 children. Incidence was highest below 5 years old (2.69 per 100,000 children). Most of patients were presented clinically by bloody diarrhea, pallor, oliguria & anuria. Laboratory abnormalities included hemolytic anemia, thrombocytopenia, leukocytosis, hyponatremia, hypokalemia or hyperkalemia, metabolic acidosis, elevated blood urea and serum creatinine. Stool culture was positive in only 7 cases (17%).The mortality rate was 21.4%.
Conclusion: Unfavorable outcome was associated with young age, anuria, intractable seizures, high WBC count more than 30,000 per mm3 ,and hyperkalemia above 5 m mol/ L.
Key words: Hemolytic Uremic Syndrome, Shiga-toxin, Acute Kidney Injury, Hemodialysis, Complement, TMA, MAHA.