[Markers of thrombin generation in kidney failure of children with epidemic hemolytic uremic syndrome].
We present herein the levels of the early markers of blood coagulation activation and TNF-alpha in 12 children with the epidemic form of the hemolytic-uremic syndrome, median age 16 months, range 12-18. All patients recovered from the disease within 2 to 4 weeks. Four blood samples were collected: at admission, 1 week and 2 weeks later and on remission. Prothrombin fragments 1 + 2 (F1 + 2), thrombin-antithrombin complex (TAT) and tumor necrosis factor alpha (TN-alpha) were assayed by commercial ELISA techniques, while von Willebrand factor (vWf) was measured by Laurell's method. At admission, F1 + 2 and TAT levels were 7.8 nM (3.7-12.3) and 22.7 ng/ml (8-76), respectively. Besides, significant correlations were obtained for F1 + 2 levels vs blood creatinine, r: 0.57 p < 0.001; F1 + 2 vs urea, r: 0.66 p < 0.001; TAT vs blood creatinine, r: 0.77 p < 0.001; TAT vs blood urea, r: 0.59 p < 0.001. Median vWf value at admission in 11/12 children was 260% (170-420), correlating with F1 + 2, r: 0.77 p < 0.001 and with TAT, r: 0.41 p < 0.01. Such values tended to normalize with the improvement of the disease. A negative correlation was found for platelet count vs F1 + 2, r: -0.64 p < 0.001. TNF-alpha levels were increased in 5/12 children, 22.2 pg/ml (17.2-53.7). These results may be attributable to similar stimuli on endothelial cells.
Sección Nefrología, Hospital de Pediatría Juan P. Garrahan.
R F
RF
Marta
L
L
Florentin
M
M
Díaz
P
P
Indaburu
J C
JC
Sánchez Avalos
F C
FC
Molinas
D000991:Antithrombins / Q000032:analysis*; D015415:Biomarkers; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D006463:Hemolytic-Uremic Syndrome / Q000097:blood* / Q000150:complications; D006801:Humans; D007223:Infant; D011516:Prothrombin / Q000032:analysis*; D051437:Renal Insufficiency / Q000097:blood* / Q000150:complications; D013917:Thrombin / Q000096:biosynthesis*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*; D014508:Urea / Q000097:blood; D014841:von Willebrand Factor / Q000032:analysis
D000991:Antithrombins; D015415:Biomarkers; D014409:Tumor Necrosis Factor-alpha; D014841:von Willebrand Factor; D014508:Urea; D011516:Prothrombin; D003404:Creatinine; D013917:Thrombin