Cardiac ischemia during hemolytic uremic syndrome.
Increased thrombin generation and impaired fibrinolysis during Escherichia coli O157:H7-associated hemolytic uremic syndrome (HUS) plausibly diminish myocardial blood flow, but the frequency of cardiac ischemia during HUS is unknown. We identified a 9-year-old boy with HUS in whom myocardial diastolic dysfunction was demonstrated by echocardiography, who also had elevated serum troponin-I and creatine kinase MB mass. However, eight additional patients with HUS did not have elevated markers of cardiac injury. When present, elevated troponin-I should be considered to represent myocardial injury, and not attributed simply to renal insufficiency. It is possible that myocardial ischemia and secondary arrhythmias account for some sudden deaths that occur during acute HUS.
Thayu
Meena
M
Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.
Chandler
Wayne L
WL
Jelacic
Srdjan
S
Gordon
Carrie A
CA
Rosenthal
Geoffrey L
GL
Tarr
Phillip I
PI
D015415:Biomarkers; D002648:Child; D003402:Creatine Kinase / Q000378:metabolism; D052279:Creatine Kinase, MB Form; D019453:Escherichia coli O157; D006463:Hemolytic-Uremic Syndrome / Q000150:complications* / Q000382:microbiology; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism; D008297:Male; D017202:Myocardial Ischemia / Q000209:etiology*; D019210:Troponin I / Q000378:metabolism
D015415:Biomarkers; D007527:Isoenzymes; D019210:Troponin I; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form