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10.1186/s12879-016-1627-7

http://scihub22266oqcxt.onion/10.1186/s12879-016-1627-7
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suck abstract from ncbi


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pmid27297224
      BMC+Infect+Dis 2016 ; 16 (ä): 285
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  • Clinical features, therapeutic interventions and long-term aspects of hemolytic-uremic syndrome in Norwegian children: a nationwide retrospective study from 1999-2008 #MMPMID27297224
  • Jenssen GR ; Vold L ; Hovland E ; Bangstad HJ ; Nygård K ; Bjerre A
  • BMC Infect Dis 2016[Jun]; 16 (ä): 285 PMID27297224 show ga
  • BACKGROUND: Hemolytic-uremic syndrome (HUS) is a clinical triad of microangiopathic hemolytic anemia, impaired renal function and thrombocytopenia, primarily affecting pre-school-aged children. HUS can be classified into diarrhea-associated HUS (D(+)HUS), usually caused by Shiga toxin-producing Escherichia coli (STEC), and non-diarrhea-associated HUS (D(-)HUS), both with potentially serious acute and long-term complications. Few data exists on the clinical features and long-term outcome of HUS in Norway. The aim of this paper was to describe these aspects of HUS in children over a 10-year period. METHODS: We retrospectively collected data on clinical features, therapeutic interventions and long-term aspects directly from medical records of all identified HUS cases <16 years of age admitted to Norwegian pediatric departments from 1999 to 2008. Cases of D(+)HUS and D(-)HUS are described separately, but no comparative analyses were possible due to small numbers. Descriptive statistics are presented in proportions and median values with ranges, and/or summarized in text. RESULTS: Forty seven HUS cases were identified; 38 D(+)HUS and nine D(-)HUS. Renal complications were common; in the D(+)HUS and D(-)HUS group, 29/38 and 5/9 developed oligoanuria, 22/38 and 3/9 needed dialysis, with hemodialysis used most often in both groups, and plasma infusion(s) were utilized in 6/38 and 4/9 patients, respectively. Of extra-renal complications, neurological complications occurred in 9/38 and 2/9, serious gastrointestinal complications in 6/38 and 1/9, respiratory complications in 10/38 and 2/9, and sepsis in 11/38 and 3/9 cases, respectively. Cardiac complications were seen in two D(+)HUS cases. In patients where data on follow up ?1 year after admittance were available, 8/21 and 4/7 had persistent proteinuria and 5/19 and 4/5 had persistent hypertension in the D(+)HUS and D(-)HUS group, respectively. Two D(+)HUS and one D(-)HUS patient were diagnosed with chronic kidney disease and one D(+)HUS patient required a renal transplantation. Two D(+)HUS patients died in the acute phase (death rate; 5 %). CONCLUSIONS: The HUS cases had a high rate of complications and sequelae, including renal, CNS-related, cardiac, respiratory, serious gastrointestinal complications and sepsis, consistent with other studies. This underlines the importance of attention to extra-renal manifestations in the acute phase and in renal long-term follow-up of HUS patients.
  • |*Blood Transfusion [MESH]
  • |*Plasmapheresis [MESH]
  • |*Renal Replacement Therapy [MESH]
  • |*Respiration, Artificial [MESH]
  • |Adolescent [MESH]
  • |Anti-Bacterial Agents/*therapeutic use [MESH]
  • |Child [MESH]
  • |Child, Preschool [MESH]
  • |Diarrhea/etiology [MESH]
  • |Escherichia coli Infections/complications/physiopathology/*therapy [MESH]
  • |Female [MESH]
  • |Heart Diseases/etiology [MESH]
  • |Hemolytic-Uremic Syndrome/complications/physiopathology/*therapy [MESH]
  • |Humans [MESH]
  • |Hypertension/etiology [MESH]
  • |Infant [MESH]
  • |Kidney [MESH]
  • |Kidney Failure, Chronic/etiology [MESH]
  • |Kidney Transplantation [MESH]
  • |Male [MESH]
  • |Nervous System Diseases/etiology [MESH]
  • |Norway [MESH]
  • |Proteinuria/etiology [MESH]
  • |Renal Dialysis [MESH]
  • |Renal Insufficiency, Chronic/etiology [MESH]
  • |Respiratory Tract Diseases/etiology [MESH]
  • |Retrospective Studies [MESH]
  • |Sepsis/etiology [MESH]


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