Neuropsychological sequelae of haemolytic uraemic syndrome

Abstract

Background-Severe haemolytic uraemic syndrome (HUS) in childhood can cause stroke, hemiplegia, cortical blindness, and psychomotor retardation. These outcomes are evident at the time of discharge immediately after the acute illness. Less is known about the neuropsychological outcomes of less severely aVected children who recover from acute HUS. Aims-This multicentre case control study investigated the hypothesis that children who survive an acute episode of HUS without recognisable neurological injuries have greater impairment of cognitive, academic, and behavioural functions than controls. Design-Children with HUS were eligible if they had no evidence of severe neurological dysfunction when discharged from one of six Canadian hospitals. Controls had been admitted to hospital for a non-HUS illness and were matched by age, sex, first language, and socioeconomic status. All subjects underwent evaluation of behaviour, academic achievement, cognitive function, and verbal abilities using standardised tests administered by a psychometrist blinded to the case or control status. Results-Ninety one case control pairs were enrolled. No important diVerences between patients with HUS and paired controls were evident on tests of IQ, behaviour, verbal abilities, or academic achievement. There was no increased risk of attention deficit disorder among patients with HUS. There was no correlation between the severity of acute renal failure and neuropsychological measures, although scores on some verbal ability tests were lower in those with the highest serum creatinine concentrations during illness. Conclusions-Children discharged from hospital without apparent neurological injury after an episode of acute HUS do not have an increased risk of subclinical problems with learning, behaviour, or attention. (Arch Dis Child 1999;80:214-220)

Cognitive deficits after recovery from thrombotic thrombocytopenic purpura

“…In an autopsy study, microvascular thrombosis was present in the kidneys of all children but no microthrombi were observed in the brain 22 . This is consistent with the absence of cognitive abnormalities in children after recovery from HUS 23 . Although persistent cognitive abnormalities may suggest the possibility of persistent activity of TTP, there were no symptoms or signs of TTP among these 24 patients.…”

Neuropsychological Outcome after Complicated Shiga Toxin–Producing Escherichia coli Infection

“…These findings are consistent with previous studies in children [6]. Furthermore, the outcome is not linked to characteristic MRI-changes.…”

“…Children with HUS and without apparent neurological symptoms do not show any difficulties with learning, behavior or attention when compared to matched controls [6].…”

Shiga Toxin-Associated Hemolytic Uremic Syndrome: A Narrative Review

“…Next to renal sequelae, the most feared long-term complications after STEC-HUS are related to the central nervous system. Even if intellectual performance does not seem to be impaired in children [412], subtle neuromotor impairment has been described in most of them, independently of acute central nervous system involvement [413]. Neuropsychological symptoms, including fatigue, headache, and attention deficits, were present in 70% of adult patients 19 months after the O104:H4 outbreak [414].…”