title: Common association of haemolytic uraemic syndrome with invasive Streptococcus pneumoniae infection in five Chinese paediatric patients.
abstract: Haemolytic uraemic syndrome is an important cause of acute renal impairment in childhood. We review the incidence, and clinical and laboratory features of haemolytic uraemic syndrome in a Chinese population. Five patients were identified from 2006 to 2008. All patients were young children with associated invasive Streptococcus pneumoniae pulmonary infection. Serotypes 3, 14, and 19A were confirmed in four patients. The classical post-diarrhoeal form associated with Escherichia coli (O157:H7) infection was not seen. One patient died of acute respiratory failure. Streptococcus pneumoniae infection, as an associated condition in haemolytic uraemic syndrome, is important and relatively common in Chinese patients, especially among children. The acute clinical picture is similar to that reported in the western literature, except for an uncommon association with meningitis. The medium-term renal outcome of the Chinese population appears to be more favourable than the Caucasians. Widespread vaccination against Streptococcus pneumoniae may have resulted in changes in bacterial epidemiology and clinicians should be continuously aware of this severe disease. The use of washed blood components for transfusion in the acute stage requires further study.
authors.affiliation: Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong. scc@pathology.hku.hk
authors.forename: C C
authors.initials: CC
authors.lastname: So
authors.forename: Y Y
authors.initials: YY
authors.lastname: Leung
authors.forename: S F
authors.initials: SF
authors.lastname: Yip
authors.forename: S Y
authors.initials: SY
authors.lastname: Chan
authors.forename: Clarence C K
authors.initials: CC
authors.lastname: Lam
authors.forename: Godfrey C F
authors.initials: GC
authors.lastname: Chan
authors.forename: Stella
authors.initials: S
authors.lastname: Chim
authors.forename: L C
authors.initials: LC
authors.lastname: Chan
mesh_terms: D002675:Child, Preschool; D002681:China; D005260:Female; D005500:Follow-Up Studies; D006463:Hemolytic-Uremic Syndrome / Q000382:microbiology*; D006801:Humans; D008297:Male; D011008:Pneumococcal Infections / Q000150:complications* / Q000382:microbiology; D012131:Respiratory Insufficiency / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000382:microbiology; D012189:Retrospective Studies; D012703:Serotyping; D012720:Severity of Illness Index; D013296:Streptococcus pneumoniae / Q000145:classification / Q000302:isolation & purification*