Haemolytic uraemic syndrome: prognostic factors.
Haemolytic uraemic syndrome (HUS) associated with Escherichia coli O157:H7 is the commonest cause of acute renal failure (ARF) in childhood. Production of verotoxin by the organism is pivotal in the pathogenesis of the disease. Verotoxin binds to a receptor on blood and endothelial cells, expressed as the P1 blood group antigen on red blood cells. A protective effect of the P1 phenotype has been proposed in this disease. This study investigates prognostic factors and the relationship between outcome and P1 phenotype in 27 cases of diarrhoea-associated HUS. A poor outcome as defined by the presence of chronic renal failure (CRF), hypertension or proteinuria on 6 month follow-up was associated with the age of the patient at presentation and with the following clinical markers: maximum WBC and duration of raised WBC, duration of anuria and duration of need for dialysis. None of these outcome measures or prognostic factors, and no extra-renal manifestations of the disease were associated with P1 phenotype.
Green
D A
DA
Royal Hospital for Sick Children, Royal Infirmary, Edinburgh, UK.
Murphy
W G
WG
Uttley
W S
WS
D058186:Acute Kidney Injury / Q000209:etiology / Q000276:immunology / Q000382:microbiology; D000367:Age Factors; D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000382:microbiology; D004927:Escherichia coli Infections / Q000150:complications / Q000453:epidemiology / Q000276:immunology; D019453:Escherichia coli O157; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000276:immunology; D007223:Infant; D008297:Male; D010127:P Blood-Group System / Q000235:genetics; D010641:Phenotype; D011379:Prognosis; D011507:Proteinuria / Q000209:etiology / Q000276:immunology; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012737:Sex Factors
D015415:Biomarkers; D010127:P Blood-Group System