title: The functional state of neutrophils correlates with the severity of renal dysfunction in children with hemolytic uremic syndrome.
abstract: Hemolytic Uremic Syndrome (HUS) is the main cause of acute renal failure in children. The high percentage of patients who develop long-term sequelae constitutes an important medical concern. The identification of parameters that correlate with the degree of renal failure may be useful to plan the best treatment soon after hospitalization. Here, we investigated the functional state of neutrophils (PMN) from HUS patients on admission, before dialysis and/or transfusion, in relation to the severity of renal impairment reached during the acute period (AP). We found that all PMN activation parameters measured in severe cases of HUS (HUS AP3) were statistically lower comparing to children with mild cases of HUS (HUS AP1). As HUS PMN phenotype and dysfunction is compatible with that of cells undergoing cell death, we also studied spontaneous apoptosis. Not only were HUS PMN not apoptotic, but HUS AP3 PMN showed an increased survival. Almost all phenotypic and functional parameters measured on PMN correlated with severity. Our results revealed a marked deactivation of PMN in severe cases of HUS, and suggest that studying the functional state of PMN could be of prognostic value.
authors.affiliation: Division of Immunology, Institute of Hematological Investigations, National Academy of Medicine, C1425AUM Buenos Aires, Argentine. gfernandez@hematologia.anm.edu.ar
authors.forename: Gabriela C
authors.initials: GC
authors.lastname: Fernandez
authors.forename: Sonia A
authors.initials: SA
authors.lastname: Gomez
authors.forename: Maria V
authors.initials: MV
authors.lastname: Ramos
authors.forename: Leticia V
authors.initials: LV
authors.lastname: Bentancor
authors.forename: Romina J
authors.initials: RJ
authors.lastname: Fernandez-Brando
authors.forename: Veronica I
authors.initials: VI
authors.lastname: Landoni
authors.forename: Laura
authors.initials: L
authors.lastname: Lopez
authors.forename: Flavia
authors.initials: F
authors.lastname: Ramirez
authors.forename: Mario
authors.initials: M
authors.lastname: Diaz
authors.forename: Marta
authors.initials: M
authors.lastname: Alduncin
authors.forename: Irene
authors.initials: I
authors.lastname: Grimoldi
authors.forename: Ramon
authors.initials: R
authors.lastname: Exeni
authors.forename: Martin A
authors.initials: MA
authors.lastname: Isturiz
authors.forename: Marina S
authors.initials: MS
authors.lastname: Palermo
mesh_terms: D002675:Child, Preschool; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D009504:Neutrophils / Q000502:physiology*; D011379:Prognosis