[Hemolytic uremic syndrome in children].
In Europe, haemolytic uraemic syndrome (HUS) is the most frequent cause of acute renal insufficiency during childhood. In the Netherlands about 20 children per year are seriously affected. Following a prodromal phase of mostly bloody diarrhoea, the main symptoms become evident, namely, haemolytic anaemia, thrombocytopenia and renal failure. The syndrome is caused by a verocytotoxin producing Escherichia coli, which damages the endothelium of the arterioles and glomeruli in the kidney. In humans, the most important cause of infection is the consumption of infected food-stuffs. After transport through the intestinal epithelium, the toxin becomes attached to the neutrophils, which transport it through the circulatory system, mainly to the kidneys where it has a toxic effect. Why the endothelial cells in these organs are the main targets for this toxin is as yet unknown. A symptomatic treatment is given to the 10% of infected patients who develop HUS. Increasing knowledge about the pathogenesis has resulted in new forms of treatment that will be studied during the next few years.
Heuvelink
A E
AE
Keuringsdienst van Waren Oost, afd. Signalering Veterinaire Producten, Zutphen.
te Loo
D M
DM
Monnens
L A
LA
D058186:Acute Kidney Injury / Q000209:etiology* / Q000382:microbiology; D000327:Adsorption; D000900:Anti-Bacterial Agents; D000992:Antitoxins / Q000627:therapeutic use; D002648:Child; D000075202:Contraindications; D004927:Escherichia coli Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism; D019453:Escherichia coli O157 / Q000472:pathogenicity*; D006463:Hemolytic-Uremic Syndrome / Q000150:complications / Q000453:epidemiology / Q000378:metabolism / Q000382:microbiology / Q000401:mortality; D006801:Humans; D015994:Incidence; D009426:Netherlands; D017646:Organosilicon Compounds / Q000627:therapeutic use; D022622:Shiga Toxin 1 / Q000378:metabolism*; D014312:Trisaccharides / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000992:Antitoxins; D017646:Organosilicon Compounds; C119238:SYNSORB Pk; D022622:Shiga Toxin 1; D014312:Trisaccharides