Gastrointestinal complications of post-diarrheal hemolytic uremic syndrome.
OBJECTIVE
Whereas gastrointestinal symptoms such as vomiting, diarrhea and abdominal pain are common in children suffering from the so-called post-diarrheal form (D+) of hemolytic uremic syndrome (HUS), more serious gastrointestinal complications are rare. We tried to define factors predictive of the severity of gastrointestinal complications post D+ HUS.


METHODS
We reviewed the files of all children admitted to our hospital for D+ HUS between 1988 and 2000. We retained those cases with gastrointestinal complications and analyzed the consequences of these complications on the evolution of the children's conditions.


RESULTS
Sixty-five children with D+ HUS were admitted to our hospital during this period. Sixteen children developed gastrointestinal complications involving one or more digestive organs: necrosis of the colon or ileum, hemorrhagic colitis, pancreatitis, transient diabetes, hepatic cytolysis and cholestasis, peritonitis and prolapse of the rectum. One child died.


CONCLUSIONS
Gastrointestinal complications of D+ HUS are rare, but they can be lethal, and early surgery may sometimes prove necessary. However, we were not able to demonstrate a correlation between the severity of the gastrointestinal manifestations and the clinical or biological signs accompanying D+ HUS.
de Buys Roessingh
A S
AS
Department of Pediatric Surgery, University Hospital of Robert Debré, AP-HP, Paris, France. Anthony.debuys-roessingh@CHUV.ch
de Lagausie
P
P
Baudoin
V
V
Loirat
C
C
Aigrain
Y
Y
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006463:Hemolytic-Uremic Syndrome / Q000150:complications*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index