An outbreak of hemolytic uremic syndrome in southern Romania during 2015–2016: Epidemiologic, clinical, laboratory, microbiologic, therapeutic and outcome characteristics

Bălgrădean, Mihaela; Croitoru, Anca; Leibovitz, Eugene

doi:10.1016/j.pedneo.2018.04.011

Cited by 9 publications

(6 citation statements)

References 38 publications

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“…Hemolytic uremic syndrome (HUS) is described as a multisystemic disease 6,7 that affects mainly the kidney and is a major cause of morbidity and mortality in children under the age of 5 years old 1 . The kidney and brain are the main target organs affected in patients with HUS 2 .…”

Section: Discussionmentioning

confidence: 99%

Neurological complications in patients with typical hemolytic uremic syndrome

Costin¹,

BANULESCU²,

Atanasescu³

et al. 2020

Arch Balk Med Union

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Section: Discussionmentioning

confidence: 99%

Neurological complications in patients with typical hemolytic uremic syndrome

Costin¹,

BANULESCU²,

Atanasescu³

et al. 2020

Arch Balk Med Union

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“…This form of culture medium had been in limited use in New Zealand laboratories. However, the advent of nucleic acid amplification technology and toxin enzyme immunoassays has demonstrated that non-O157:H7 STEC serotypes can also cause HUS [11][12][13][14]. STEC-HUS is a common cause of acute kidney injury (AKI) in children requiring acute kidney replacement therapy in developed countries [15][16][17].…”

Section: Methodsmentioning

confidence: 99%

Untitled

2022

Int J Pediatr Res

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Background:The epidemiology of childhood haemolytic uraemic syndrome in New Zealand was on active surveillance from January 1, 1998 to December 31, 2020. The aim of this study is to describe the demographic, epidemiological and some clinical features of childhood Shiga toxin producing E. coli infections (STEC) and its association with diarrhoea associated haemolytic uremic syndrome (D+HUS) over past 23 years. Methods:The New Zealand Paediatric Surveillance Unit (NZPSU) sent out a monthly report card to all practising paediatricians with conditions under active surveillance. Those paediatricians who had cared for a child aged 0 to 15 years of age with D+HUS in the past month were requested to report their patient to the NZPSU. The reporting clinicians were then contacted by the principal investigator who sent out a questionnaire to the clinician requesting patient clinical and laboratory information. The group was divided into 2 cohorts; A: 1998-2008 and B: 2009-2020 to examine trends in STEC infections and childhood D+HUS.Results: Two hundred and twenty six children aged 3 months up to 15 years (median 2.8 years (IQR 1.7-4.9) were diagnosed with D+HUS. E. coli O157: H7 was identified in 130 (57.1%) and 8 were due to serotypes 026 H11 and 0113. Over the 23 years, the mean annual incidence in children under age 5 between cohort A and cohort B was not statistically significant (2.2 per 100,000 vs. 2.85 per 100,000. The mean annual incidence was 1.2 per 100,000 in all children under age 15 for the whole study period. Disease severity as measured by the requirement for acute dialysis had not changed and was required in 128/226 (56.2%) of children for a median of 9 days (range 1-38). The overall mortality was 3/226 (1.3%), which was due exclusively to severe cerebral injury. Conclusion:There has been an increase in STEC infections in childhood over the past 23 years, in part due improved methods of detection, however, the incidence children developing D+HUS has remained stable over the study period. E. coli serotypes other than O157:H7 have increased in prevalence over the past 6 years due to methodological changes in diagnostic laboratories, but with only a small number of infected children developing D+HUS. The mortality rate over the study period was low, consistent with other reported series.

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“…Bizim çalışma grubumuzun ortanca yaşı literatür ile uyumlu olup 18 ay olarak hesaplandı (Tablo 1). Diyare ilişkili HÜS için cinsler arasında bir fark tanımlanmamıştır (2)(3)(4)(5)(6)(7)(8)11,(15)(16)(17)(18)(19). Çalışmamızda 9 (%60) erkek hasta olup cinsler arasında anlamlı fark görülmedi.…”

Section: Bulgularunclassified

“…Literatür ile uyumlu olarak hastalarımızın %60'ında BYKT ihtiyacı gözlendi (7,11,18,20,21,26,27). Diyare ilişkili HÜS hastalarında ortalama BYKT tedavisi süreleri 10-18,5 gün aralığında olduğu bildirilmektedir (1,7,8,17,18,21). Bizim çalışmamızda da ortalama BYKT süresi literatür ile uyumlu olup, 15,11±9,11 gün olarak hesaplandı.…”

Section: Bulgularunclassified

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Çocuk Yoğun Bakımda Diyare İlişkili Hemolitik Üremik Sendrom: Tek Merkez Deneyimi

Alparslan¹,

Talay²

2021

jchild

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Hemolitik üremik sendrom, akut böbrek hasarı, hemolitik anemi ve trombositopeni ile karakterizedir. Çocuklarda en sık diyare ilişkili HÜS (D+ HÜS) olarak görülmektedir. Bu çalışmada amaç D+HÜS klinik parametrelerinin ve hastalığın sonlanımı açısından öngördürücülerin belirlenmesidir. Gereç ve Yöntem: Geriye dönük olarak yapılan bu çalışmaya Mart 2019 -Ağustos 2020 tarihleri arasında çocuk yoğun bakımda D+HÜS tanısı alan 15 hasta dahil edildi. Olguların demografik özellikleri, başvuru yaşamsal bulguları, laboratuvar parametreleri (hemoglobin, hemotokrit, beyaz kan hücresi, trombosit, kreatinin, üre, ürik asit, laktat dehidrogenaz, aspartat aminotransferaz, alanin aminotransferaz, amilaz, albümin, C3 ve C4), plazma tedavisi, plazma değişimi, böbrek yerine koyma tedavisi (BYKT) uygulandıysa tipi ve süresi, kan ürünü ihtiyacı olup olmadığı incelendi. Ayrıca olgularda böbrek dışında organ tutulumu varlığı, eculizumab tedavisi kullanımı ve izlemde son durumları kayıt altına alındı. Bulgular: Çalışma grubunun 9'u (%60) erkek olup, yaş ortalaması ortanca 18 ay olarak hesaplandı. Tüm çalışma grubunun %60'ında BYKT ihtiyacı olup, periton diyalizinin [5 (%33,3)] en sık tercih edilen yöntem olduğu görüldü. Beş olguda (%33,3) böbrek dışı organ tutulumu izlendi. Taburculuk sonrası izlem süresince (ort:9,59±6,03 ay), 9 (%60)'unun normale döndüğü, 3 (%20)'ünün proteinüri, 1 (%6,6)'inde kronik böbrek hastalığı, 1 (%6,6)'inde son dönem böbrek yetmezliği ve 1 (%6,6)'inde de nörolojik sekel kaldığı görüldü. Hastane yatış ve oligoanüri süresinin sekel gelişimi üzerine istatistiksel olarak anlamlı etkisi olduğu görüldü [Hastane yatış süre: OR:1,28 (%95 CI:0,77-0,98) (p=0,04), Oligoanüri süre: OR:1,46 (%95 CI:0,94-1) (p=0,04)]. Sonuç: Bu çalışmada hastane yatış ve oligoanüri süresinin sekel gelişimi üzerine anlamlı etkisi gösterildi. Bu hastalığın daha iyi tanınarak yönetiminin geliştirilmesi ile bu kötü sonuçların azaltılabilmesi için daha çok klinik çalışmaya ihtiyaç olduğunu düşünmekteyiz.

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An outbreak of hemolytic uremic syndrome in southern Romania during 2015–2016: Epidemiologic, clinical, laboratory, microbiologic, therapeutic and outcome characteristics

Abstract: The principal STEC serotype involved was O:H and the number of confirmed HUS cases reached half of the patients. Compared with the medical literature, this outbreak had a higher rate of complications and renal sequelae and was associated with a high fatality rate.

Cited by 9 publications

References 38 publications

Neurological complications in patients with typical hemolytic uremic syndrome

Neurological complications in patients with typical hemolytic uremic syndrome

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Çocuk Yoğun Bakımda Diyare İlişkili Hemolitik Üremik Sendrom: Tek Merkez Deneyimi

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