Childhood hemolytic uremic syndrome in Jordan

ABSTRACT

Hemolytic Uremic Syndrome [HUS] is the most common cause of Acute Kidney Injury [AKI] in the developed countries. It consists of Microoangiopathic Hemolytic Anemia [MAHA], AKI and thrombocytopenia. To review the outcome of childhood Diarrhea-associated Hemolytic Uremic Syndrome [D+HUS] presenting to the pediatric department at Jordan University Hospital [JUH]. In this retrospective study war reviewed the medical rectors of children presenting to JUH between January 1977 and January 2008 with D+HUS. There were 21 patients [15 girls and 6 boys]. Age ranged from 6 months to 11 years. 8 children [38%] had Entamoeba histolytica infection. 57% needed peritoneal dialysis. Central nervous system manifestations included drowsiness in 8 patients [38.1%], limb weakness in 2 patients [9.5%], seizures in 9 patients [43%], irritability 3 patients [14%], transient blindness in 2 patients [9.5%], and uremic encephalopathy in 1 patient [4.8%]. Complete recovery in 11 patients [52.4%], chronic kidney disease in 6 patients [28.6%], central nervous system deficit in 2 patients, and death in 2 patients [9.5%]. There was no correlation between the outcome and the presence of leukocytosis, thrombocytopenia, severity of renal failure, hyponatremia, or hypertension [p<0.05]. Our data highlights the importance of D+HUS in the pediatric age group. In addition, it emphasizes its manifestations, complications, and outcome: