[Prognosis of hemolytic uremic syndrome in children. Importance of extrarenal involvement].
The prognosis of hemolytic uremic syndrome was studied in 37 children hospitalized between January 1980 and January 1985. 75% of affected children were less than 3 years of age. Twenty-two (60%) presented with anuria or oliguria (mean duration of anuria: 10.7 days). In this last group, severe extrarenal manifestations occurred: 12 cases of neurological involvement (6 involving hypervolemia), gastrointestinal involvement in 5 cases, including a case of ileal necrosis; pancreatic involvement in another. Three children died during the first month of the disease (overall death-rate: 8%). Thirty-two children were followed with a mean 24 months follow-up (6 months to 60 months). Six (19%) presented with sequellae, of which 3 were severe: one severe arterial hypertension and two with chronic renal failure of which one terminal with severe neurologic sequellae. The existence of extrarenal manifestations implies a poor prognosis. Among the 22 children with anuria or oliguria, 8 had no extra-renal manifestations. All of these recovered. Three of 11 children with one extrarenal manifestation had an unfavorable outcome. The course was unfavorable in the 3 cases with multiple extrarenal involvement.
D001002:Anuria / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000209:etiology; D004066:Digestive System Diseases / Q000209:etiology; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007223:Infant; D007674:Kidney Diseases / Q000209:etiology; D008297:Male; D010182:Pancreatic Diseases / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology
Pronostic du syndrome hémolytique et urémique chez l'enfant. Importance de l'atteinte extra-rénale.