title: Occurrence of atypical HUS associated with influenza B.
abstract: Hemolytic uremic syndrome (HUS) is a disease characterized by thrombotic microangiopathy with a triad of non-immune hemolytic anemia, thrombocytopenia, and renal impairment. Approximately 10% of cases of HUS are classified as atypical (aHUS). While today many genetically forms of aHUS pathology are known, only about 50% of carriers precipitate the disease. The reason remains unclear, and triggering events like intercurrent infections have been postulated. In rare cases, influenza A is the known trigger of aHUS; however, no cases of influenza B have been reported.
  
  
  CONCLUSIONS
  We describe for the first time that influenza B strain as a trigger for aHUS in children with primary hereditary forms. We also showed in our three cases that immunization appears to be safe; however, this needs to be confirmed in a larger cohort. What is Known: • Known triggers of aHUS are infectious specimen. • Influenza A-associated aHUS cases are rarely published. What is New: • aHUS can be triggered by influenza B virus infection. • Influenza vaccination of patients with aHUS appears safe.
authors.affiliation: Department of Pediatric Nephrology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. karenvanhoeve@yahoo.be.
authors.forename: Karen
authors.initials: K
authors.lastname: van Hoeve
authors.affiliation: University Vaccinology Center, KU Leuven - University of Leuven, 3000, Leuven, Belgium.
authors.forename: Corinne
authors.initials: C
authors.lastname: Vandermeulen
authors.affiliation: Department of Microbiology and Immunology, KU Leuven - Rega Institute, 3000, Leuven, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Van Ranst
authors.affiliation: Department of Pediatric Nephrology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.|Laboratory of Pediatrics, KU Leuven - University of Leuven, 3000, Leuven, Belgium.
authors.forename: Elena
authors.initials: E
authors.lastname: Levtchenko
authors.affiliation: Laboratory of Pediatrics, KU Leuven - University of Leuven, 3000, Leuven, Belgium.
authors.forename: Lambert
authors.initials: L
authors.lastname: van den Heuvel
authors.affiliation: Department of Pediatric Nephrology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.|Laboratory of Pediatrics, KU Leuven - University of Leuven, 3000, Leuven, Belgium.
authors.forename: Djalila
authors.initials: D
authors.lastname: Mekahli
mesh_terms: D000293:Adolescent; D065766:Atypical Hemolytic Uremic Syndrome / Q000097:blood / Q000235:genetics* / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D002648:Child; D003401:Creatine / Q000097:blood*; D006801:Humans; D009981:Influenza B virus / Q000235:genetics*; D008297:Male; D009154:Mutation; D010951:Plasma Exchange; D012008:Recurrence
chemical_list: D015415:Biomarkers; D003401:Creatine
keywords: Atypical hemolytic uremic syndrome; Hemolytic uremic syndrome; Influenza B; Vaccination