title: [Hemolytic-uremic syndrome (HUS) in children at the University Hospital Center in Dakar: about four cases].
abstract: Hemolytic-uremic syndrome (HUS) is a common cause of organic acute renal failure (ARF) in children. It is a progressive complication of acute gastroenteritis (AGE), especially caused by Escherichia coli in children. This study aimed to describe the clinical, therapeutic and evolutionary aspects of this affection in four children. We collected four cases of HUS. The average age was 10,5 months (5-15mois), exclusively boys. Clinical examination revealed a hemolytic anemia (pallor and jaundice), oligoanuria and edematous syndrome (2 cases), arterial hypertension (1 patient), AGE associated with severe dehydration and hypovolemic shock (2 patients), consciousness disorders. ARF was found in all patients as well as thrombocytopenia and schizocytes smear. Direct Coombs test was negative. Hyperkalemia was found in 3 patients, of whom 1 with hyperkalemia level of more than 9.2 mmol/L, hyponatremia at 129 mmol/l (1 patient) and hypernatremia at 153 mmol/l (1 patient). HUS was secondary to pneumococcal pneumonia (1 patient) while AGE was secondary to E. coli (1 patient). The treatment was mainly symptomatic and included fluid restriction, transfusion of red cell concentrates, diuretics, peritoneal dialysis and hemodialysis. The evolution was marked by the onset of chronic renal failure (1 patient) after 6 months of follow-up and by recovery (1 case). Three patients died. HUS is the most common cause of organic acute renal failure in newborns. Diagnosis is essentially biological, treatment is mostly symptomatic.
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Aliou
authors.initials: A
authors.lastname: Thiongane
authors.affiliation: Hôpital d'Enfants de Diamniadio, Dakar, Sénégal.
authors.forename: Aliou Abdoulaye
authors.initials: AA
authors.lastname: Ndongo
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Idrissa Demba
authors.initials: ID
authors.lastname: Ba
authors.affiliation: Service de Pédiatrie de l'Hôpital Abass Ndao, Dakar, Sénégal.
authors.forename: Djibril
authors.initials: D
authors.lastname: Boiro
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Papa Moctar
authors.initials: PM
authors.lastname: Faye
authors.affiliation: Service de Pédiatrie de l'Hôpital Aristide Le Dantec, Dakar, Sénégal.
authors.forename: Younoussa
authors.initials: Y
authors.lastname: Keita
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Aïssatou
authors.initials: A
authors.lastname: Ba
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Djeynaba Fafa
authors.initials: DF
authors.lastname: Cissé
authors.affiliation: Hôpital d'Enfants de Diamniadio, Dakar, Sénégal.
authors.forename: Idrissa
authors.initials: I
authors.lastname: Basse
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Lamine
authors.initials: L
authors.lastname: Thiam
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Indou Déme
authors.initials: ID
authors.lastname: Ly
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Babacar
authors.initials: B
authors.lastname: Niang
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Abou
authors.initials: A
authors.lastname: Ba
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Amadou Lamine
authors.initials: AL
authors.lastname: Fall
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Saliou
authors.initials: S
authors.lastname: Diouf
authors.affiliation: Service de Pédiatrie de l'Hôpital Abass Ndao, Dakar, Sénégal.
authors.forename: Ousmane
authors.initials: O
authors.lastname: Ndiaye
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Mamadou
authors.initials: M
authors.lastname: Ba
authors.affiliation: Centre Hospitalier National d'Enfants Albert Royer, Dakar, Sénégal.
authors.forename: Mamadou
authors.initials: M
authors.lastname: Sarr
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology; D004927:Escherichia coli Infections / Q000150:complications* / Q000453:epidemiology; D017809:Fatal Outcome; D005500:Follow-Up Studies; D005759:Gastroenteritis / Q000150:complications* / Q000382:microbiology; D006463:Hemolytic-Uremic Syndrome / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology; D008297:Male; D006435:Renal Dialysis / Q000379:methods; D012675:Senegal
keywords: Hemolytic-uremic syndrome; acute renal failure; schistocytes; thrombopenia