Incidence and index of severity of hemolytic uremic syndrome in a 26 year period in Fukushima Prefecture, Japan.
BACKGROUND
There have been a number of reports on large outbreaks of hemolytic uremic syndrome (HUS), but there have been no long-term studies of sporadic HUS in Japan. This study therefore investigated the epidemiology and prognosis of HUS in Fukushima Prefecture over a 26 year period.


METHODS
The medical records of 26 patients with HUS between 1987 and 2012 were collected. These children were divided into two groups: those with HUS following an episode of gastroenteritis, often with bloody diarrhea (D + HUS; n = 24) and those with HUS not associated with prodromal diarrhea (D-HUS; n = 2). The D + HUS group was further subdivided into group A (11 patients requiring dialysis) and group B (13 patients not requiring dialysis). The epidemiological and clinical data, as well as prognosis, were retrospectively investigated for each group.


RESULTS
Approximately 90% of HUS patients belonged to the D + HUS group. In this group, the mean number of patients per year from 1987 to 1999, and from 2000 to 2012 was 0.92 ± 0.95, and 1.08 ± 0.86, respectively. On admission, lactate dehydrogenase (LDH), alanine aminotransferase (ALT), blood urea nitrogen (BUN), serum creatinine and serum fibrinogen degradation product (FDP) levels in group A were all higher than in group B. Serum albumin level and estimated glomerular filtration rate (eGFR) in group A were lower than in group B. At 6 months after the onset of HUS in the D + HUS group, renal function was normal.


CONCLUSIONS
The frequency of HUS was constant from 1987 to 2012 in Fukushima. and serum LDH, ALT, BUN, creatinine, and FDP levels as well as eGFR might be risk factors for dialysis in D + HUS children.
Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan.
Yukihiko
Y
Kawasaki
Kazuhide
K
Suyama
Ryo
R
Maeda
Eichi
E
Yugeta
Kei
K
Takano
Shigeo
S
Suzuki
Hiroko
H
Sakuma
Kenji
K
Nemoto
Tomoko
T
Sato
Katsutoshi
K
Nagasawa
Mitsuaki
M
Hosoya
D002648:Child; D002675:Child, Preschool; D004190:Disasters; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D018788:Radioactive Hazard Release; D012189:Retrospective Studies; D012720:Severity of Illness Index
epidemiology; hemolytic uremic syndrome; incidence; renal insufficiency; severity