title: Hemolytic uremic syndrome (HUS)--incidence and etiologies at a regional Children's Hospital in 2001-2006.
abstract: Hemolytic uremic syndrome (HUS) is a serious health concern in children. HUS has primarily been linked to Escherichia coli O157:H7 infections, but non-O157 strains are gaining attention. Hemolytic anemia, thrombocytopenia, and acute renal failure are the characteristics of the syndrome. This study investigated the incidence of HUS at a regional Children's Hospital between 2001 and 2006 by retrospective review. Cases of HUS were investigated for outcomes based on stool culture and an association of acute pancreatitis. A total of 44 cases were identified, of which 57% were female and 43% were male, with an age distribution of 13 months to 17 years and a median age of 3.44 years. Data revealed 13 cases in 2006 compared to two cases in 2001, with 84% of all illnesses occurring in the summer and fall seasons. The median duration of thrombocytopenia was eight days and 50% of all cases required dialysis. E. coli O157:H7 was the predominant pathogen; however, 53% of the cases had unknown etiology. This data may suggest a growing number of cases from 2001 to 2006 and a role for agents other than E. coli O157:H7. E. coli O157:H7 caused longer intensive care unit (ICU) stay. No association between HUS and acute pancreatitis was found.
authors.affiliation: Creighton University School of Medicine, Omaha, NE, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Pomajzl
authors.forename: M
authors.initials: M
authors.lastname: Varman
authors.forename: A
authors.initials: A
authors.lastname: Holst
authors.forename: A
authors.initials: A
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000740:Anemia; D002648:Child; D002675:Child, Preschool; D004927:Escherichia coli Infections / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D019453:Escherichia coli O157 / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology* / Q000382:microbiology* / Q000473:pathology / Q000503:physiopathology; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D019283:Pancreatitis, Acute Necrotizing / Q000209:etiology; D006435:Renal Dialysis; D012189:Retrospective Studies; D012621:Seasons; D013921:Thrombocytopenia; D016896:Treatment Outcome; D014481:United States
references.citation: Am J Kidney Dis. 2001 Oct;38(4):E22
references.pmid: 11576909
references.citation: N Engl J Med. 1995 Aug 10;333(6):364-8
references.pmid: 7609755
references.citation: Arch Dis Child. 2008 Feb;93(2):180-1
references.pmid: 18208996
references.citation: MMWR Morb Mortal Wkly Rep. 2006 Sep 29;55(38):1045-6
references.pmid: 17008868
references.citation: Am Fam Physician. 2006 Sep 15;74(6):991-6
references.pmid: 17002034
references.citation: J Infect Dis. 2006 Feb 15;193(4):515-21
references.pmid: 16425130
references.citation: Pediatr Nephrol. 2007 Aug;22(8):1181-7
references.pmid: 17574480
references.citation: Dig Dis Sci. 2003 Feb;48(2):415-6
references.pmid: 12643624
references.citation: J Infect Dis. 2006 Sep 15;194(6):819-27
references.pmid: 16941350
references.citation: J Pediatr. 2008 Jan;152(1):106-10, 110.e1
references.pmid: 18154910
references.citation: Clin Infect Dis. 2007 Jul 1;45(1):39-45
references.pmid: 17554698
references.citation: Emerg Infect Dis. 1999 Sep-Oct;5(5):607-25
references.pmid: 10511517
references.citation: J Pediatr Gastroenterol Nutr. 1990 Nov;11(4):518-24
references.pmid: 1702151
references.citation: J Pediatr. 2007 Aug;151(2):140-4
references.pmid: 17643764
references.citation: Microb Pathog. 2001 Aug;31(2):59-67
references.pmid: 11453701
references.citation: J Infect Dis. 2005 Oct 15;192(8):1422-9
references.pmid: 16170761
references.citation: Pediatrics. 2006 May;117(5):1656-62
references.pmid: 16651320
references.citation: Clin Infect Dis. 2006 Dec 15;43(12):1587-95
references.pmid: 17109294
references.citation: Pediatr Nephrol. 2001 Oct;16(10):823-39
references.pmid: 11605791
references.citation: Emerg Infect Dis. 2000 Sep-Oct;6(5):530-3
references.pmid: 10998385
references.citation: J Infect Dis. 2001 Apr 1;183(7):1063-70
references.pmid: 11237831
references.citation: Pediatr Nephrol. 1998 Apr;12(3):222-5
references.pmid: 9630042