Hemolytic uremic syndrome associated with Shigellosis: a report of 8 cases.

During an outbreak of dysentery in the Northeastern part of Thailand, eight cases of HUS were admitted to Srinagarind Hospital from April to September 1987. Their ages ranged from 6 months to 6 years (mean age = 2.4 years). All patients had prodromal symptoms of mucous bloody diarrhea. The stool culture was positive for Shigella dysentery type I in one case. The treatment included blood transfusion, peritoneal dialysis, exchange transfusion and supportive treatment. One patient died from nosocomial septicemia. For the survivors, platelets count returned to normal after 7 to 19 days (mean 12.8 days). The duration of azotemia ranged from 12 to 36 days (mean = 20 days). One patient was azotemic during 40 days of hospitalization.

The primary nephrotic syndrome in children and histopathologic study.

A retrospective study of 91 primary nephrotic syndrome with renal biopsies from January 1979 to February 1988 was done. The age of onset is divided into three groups, there are 23.0 per cent in age group 1- less than 5 years, 44.0 per cent in group 5-10, and 33.0 per cent in age group greater than 10-15 years. The ratio male to female is 2.1:1. The histopathologic findings are 16.5 per cent MCNS, 12.0 per cent FGN, 33.0 per cent MesPGN, 30.8 per cent MPGN and 7.7 per cent MGN. This study showed that 77.7 per cent of children with primary nephrotic syndrome have the age of onset older than 5 years. The most common histopathologic finding is MesPGN which is reported to be an interchangeable form with MCNS. The result of low incidence of MCNS may be related to the high percentage of MesPGN. The high incidence of MesPGN and MPGN may result from environmental factors such as chronic infection and malnutrition. (MCNS = minimal change nephrotic syndrome, FGN = focal glomerulonephritis, MPGN = membranoproliferative glomerulonephritis, MesPGN = mesangial proliferative glomerulonephritis, MGN = membranous glomerulonephropathy).