Publication: Clinico-laboratory profile of haemolytic uremic syndrome
Date
2007
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
Objective: To study the clinical profile, the spectrum of functional abnormalities, prognostic factors and outcome of
children with haemolytic uremic syndrome (HUS).
Materials and methods: This is a prospective, descriptive, single centre, cohort study, conducted on 42 children
during the period of January 2004 to January 2005.
Results: The maximum numbers of cases were below 24 months of age with mean age of 26.6 months and male:
female ratio of 2.8:1. Most of the cases (79%) occurred in the warmer months (April-September). The common
clinical presentations were bloody diarrhoea, pallor, oliguria & anuria, fever, vomiting, abdominal distension and
pain, involvement of central nervous system, chest and cardiovascular system and bleeding manifestations. The
common haematological abnormalities were leucocytosis, thrombocytopenia, anaemia and features of haemolysis in
the peripheral blood. Electrolyte abnormalities observed were in the form of hyponatremia, hypokalemia and
hyperkalemia. Arterial blood gas analysis showed metabolic acidosis in 64% cases, where the estimations were
done. The mean blood urea and serum creatinine levels were 113.7 mg/dL and 2.5 mg/dL, respectively. Stool
examination showed blood in all cases. Urine examination showed microscopic haematuria and significant
proteinuria in 74% and 38% cases, respectively. E. coli and Shigella were isolated in stool in three cases each and
one case showed mixed growth of E. coli and Salmonella. The mortality rate was 21%. Significantly higher
mortality was observed in females, patients presenting with complete anuria, leucocytosis, hyperkalemia and
systemic involvement like central nervous system, cardio vascular system and chest.
Conclusions: Female sex, complete anuria, leucocytosis, extra renal involvement and hyperkalemia were associated
with poor outcome.
Key words: Haemolytic Uremic Syndrome, Clinical Features, Outcome, Prognostic Factors
Description
DK Jha
Department of Pediatrics and Adolescent Medicine
R Singh
Department of Pediatrics and Adolescent Medicine
S Raja
Department of Pediatrics and Adolescent Medicine,
N Kumari
Microbiology, B P Koirala Institute of Health Sciences,Dharan, Nepal
BK Das
Department of Pediatrics and Adolescent Medicine