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Clinical Features of Hemolytic Uremic Syndrome in Children

Journal of the Korean Pediatric Society 2000;43(11):1473-1479.
Published online November 15, 2000.
Clinical Features of Hemolytic Uremic Syndrome in Children
Ju Eun Lee, Su Yung Kim
Department of Pediatrics, College of Medicine, Pusan National University, Pusan, Korea
소아 용혈성 요독 증후군의 임상적 특성
이주은, 김수영
부산대학교 의과대학 소아과학교실
: 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.
: We reviewed retrospectively the medical records of 9 patients who were diagnosed the hemolytic uremic syndrome at Pusan National University during the period from January 1984 to December 1998.
: 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 patients. One was the serotype O157:H7 and the other was the serotype O26:H-, O111: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 cases, 6 recovered without residual sequelae, but two patients died, and one patient progressed to end stage renal failure.
: 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.
Key Words: Hemolytic uremic syndrome, Childhood

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