Analysis of prognostic features in children with the hemolytic uremic syndrome

ABSTRACT

The purpose of this study has been to evaluate various factors influencing prognosis in children with hemolytic-uremic syndrome [HUS]. Forty children with cfassical picture of HUS were seen in 1986-1991. Boys and girls were equally affected, aged from two months to ten years. In 35 patients [87.5%] there was a history of diarrhea which was bloody in 25. All were treated with peritoneal dialysis within the first 24 hours. Fresh frozen plasma [FFP] was transfused in the first two days for all except 11 patients for whom it was transfused in the third to fifth day of admission. Fifteen patients died [37.5%]; of these, 12[80%] had diarrhea for longer than 7 days, 11 [73%] had prominent neutrophilia, and 9 [60%] had significant neurological symptoms. Eleven of the fifteen patients had been transfused with FFP after the third day of hospitalization. Statistical analysis of data relating to mortality revealed the following regarding prognostic factors in HUS among children mortality is higher in those with longer prodromal period [p<0.001]. in those with bloody diarrhea [p<0.025], in patients with prominent neutrophilia [p<0.001], and in those who had delayed treatment with FFP [p<0.001]. Prognosis was not affected by age, sex, or season of presentation