Epidemiology of haemolytic uremic syndrome in children. Data from the North Italian HUS network.
Despite the severity of HUS and the fact that it represents a leading cause of acute kidney injury in children, the general epidemiology of HUS is all but well documented. The present study provides updated, population-based, purely epidemiological information on HUS in childhood from a large and densely populated area of northern Italy (9.6 million inhabitants, 1.6 million children). We systematically reviewed the files concerning patients with STEC-HUS and atypical HUS (aHUS) over a 10-year observation period (January 2003-December 2012). We included all incident cases with a documented first episode of HUS before the age of 18 years. We identified 101 cases of HUS during the 10 years. The overall mean annual incidence was 6.3 cases/million children aged <18 years (range 1.9-11.9), and 15.7/million of age-related population (MARP) among subjects aged <5 years; aHUS accounted for 11.9 % of the cases (mean incidence 0.75/MARP). The overall case fatality rate was 4.0 % (3.4 % STEC-HUS, 8.3 % aHUS).


CONCLUSIONS
Given the public health impact of HUS, this study provides recent, population-based epidemiological data useful for healthcare planning and particularly for estimating the financial burden that healthcare providers might have to face in treating HUS, whose incidence rate seems to increase in Northern Italy.


BACKGROUND
• HUS is a rare disease, but it represents the leading cause of acute kidney injury in children worldwide. • STEC-HUS (also called typical, D + HUS) is more common compared to atypical HUS, but recent, population-based epidemiological data (incidence) are scanty. What is New: • Comprehensive, population-based epidemiological data concerning both typical and atypical HUS based on a long observational period.
Center for Prevention, Control and Management of Hemolytic Uremic Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy. ardissino@italkid.org.
Gianluigi
G
Ardissino
Center for Prevention, Control and Management of Hemolytic Uremic Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Stefania
S
Salardi
Center for Prevention, Control and Management of Hemolytic Uremic Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Elisa
E
Colombo
Center for Prevention, Control and Management of Hemolytic Uremic Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Sara
S
Testa
Center for Prevention, Control and Management of Hemolytic Uremic Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Nicolò
N
Borsa-Ghiringhelli
Center for Prevention, Control and Management of Hemolytic Uremic Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Fabio
F
Paglialonga
Center for Prevention, Control and Management of Hemolytic Uremic Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Valentina
V
Paracchini
Center for Prevention, Control and Management of Hemolytic Uremic Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Francesca
F
Tel
Center for Prevention, Control and Management of Hemolytic Uremic Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Ilaria
I
Possenti
Center for Prevention, Control and Management of Hemolytic Uremic Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Mirco
M
Belingheri
Center for Prevention, Control and Management of Hemolytic Uremic Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Cristina Felice
CF
Civitillo
Azienda Ospedaliera Carlo Poma, Mantova, Italy.
Stefano
S
Sardini
Azienda Ospedaliera Carlo Poma, Mantova, Italy.
Rossella
R
Ceruti
Ospedale di Cittiglio, Cittiglio, Italy.
Carlo
C
Baldioli
V. Buzzi Children's Hospital, Milan, Italy.
Paola
P
Tommasi
Ospedale Fornaroli, Magenta, Italy.
Luciana
L
Parola
Azienda Ospedaliera, Desio e Vimercate, Vimercate, Italy.
Fiorella
F
Russo
Center for Prevention, Control and Management of Hemolytic Uremic Syndrome, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Silvana
S
Tedeschi
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004926:Escherichia coli / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000150:complications / Q000453:epidemiology*; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology
Acute kidney injury; Children; Epidemiology; Haemolytic uremic syndrome; Incidence