[Advances in the treatment of hemolytic uremic syndrome (HUS)].
The hemolytic uremic syndrome (HUS) is the end result of a variety of etiologic agents that can induce endothelial cell injury and thrombotic microangiopathy (TMA) mostly within the kidney. The typical, post-diarrheal verocytotoxin associated HUS (D + HUS) is the major cause of acute renal failure in children worldwide. In the course of HUS treatment, fluid overload is usually the result of overhydration in the context of oliguria or anuria which cause edema, hypertension, worsening of neurologic signs and cardiac failure. Appropriate and timely use of dialysis has dramatically reduced complications of renal failure and extra-renal complications are now the main causes of mortality and morbidity in D + HUS. The reasons for treatment by infusion of fresh frozen plasma and/or plasmapheresis for D + HUS are theoretical and their therapeutic effects are inconclusive. We believe that plasma administration for regular D + HUS has no value and is potentially harmful. Until new strategies become available in clinical practice, the general consensus for the moment is that careful supportive management with patience is still the most appropriate form of D + HUS therapy.
Ito
K
K
Department of Pediatric Nephrology, Tokyo Women's Medical College.
Shiraga
H
H
D004927:Escherichia coli Infections; D019453:Escherichia coli O157; D006463:Hemolytic-Uremic Syndrome / Q000209:etiology / Q000628:therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous; D009844:Oligosaccharides / Q000627:therapeutic use; D010949:Plasma; D010956:Plasmapheresis; D006435:Renal Dialysis; D014281:Trihexosylceramides / Q000627:therapeutic use
D016756:Immunoglobulins, Intravenous; D009844:Oligosaccharides; D014281:Trihexosylceramides; C018549:globotriaosylceramide