Haemolytic-uraemic syndrome in childhood: surveillance and case-control studies in Italy. Italian HUS Study Group.
Seventy-six cases of haemolytic-uraemic syndrome (HUS) were collected over a 4-year period during a surveillance and case-control study. The annual incidence of 0.2 per 100,000 children aged 0-14 years is lower than in other countries; 34% had no prodromal diarrhoea. Evidence for verocytotoxin-producing Escherichia coli (VTEC) infection was found in 72% of patients and 3% of controls; 88% of patients with bloody diarrhoea, 67% with non-bloody diarrhoea and 55% without diarrhoea were VTEC positive. Seventy-three percent of patients had creatinine clearance > or = 80 ml/min per 1.73 m2, normal blood pressure, no proteinuria and haematuria < 2+ after 1 year of follow-up. One patient died and none had non-renal sequelae. VTEC positivity was significantly correlated with a good outcome, while the absence of diarrhoea and a high total white blood cell count at onset were not predictors of a bad outcome. Household contacts of HUS patients had diarrhoea more frequently than those of the control group, supporting the hypothesis of person-to-person transmission of VTEC infection.
Gianviti
A
A
Division of Nephrology and Dialysis, Bambino Gesù Children's Research Hospital, Rome, Italy.
Rosmini
F
F
Caprioli
A
A
Corona
R
R
Matteucci
M C
MC
Principato
F
F
Luzzi
I
I
Rizzoni
G
G
D000293:Adolescent; D001427:Bacterial Toxins / Q000096:biosynthesis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004926:Escherichia coli / Q000378:metabolism; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D022622:Shiga Toxin 1; D011795:Surveys and Questionnaires
D001427:Bacterial Toxins; D022622:Shiga Toxin 1