title: Cardiac ischemia during hemolytic uremic syndrome.
abstract: 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.
authors.affiliation: Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.
authors.forename: Meena
authors.initials: M
authors.lastname: Thayu
authors.forename: Wayne L
authors.initials: WL
authors.lastname: Chandler
authors.forename: Srdjan
authors.initials: S
authors.lastname: Jelacic
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Gordon
authors.forename: Geoffrey L
authors.initials: GL
authors.lastname: Rosenthal
authors.forename: Phillip I
authors.initials: PI
authors.lastname: Tarr
mesh_terms: 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
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D019210:Troponin I; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form