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Extrarenal involvement in diarrhoea-associated haemolytic-uraemic syndrome

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Abstract

A review of extrarenal involvement in diarrhoea-associated haemolytic-uraemic syndrome (HUS) is based on 64 of our autopsied patients and an update of the literature.

Large bowel pathology was the commonest (29 cases), followed by the central nervous system (21 cases), the heart (19 cases) and the pancreas (19 cases). The severity of systemic involvement was associated with the magnitude of renal compromise and the prognosis of the acute phase. Diarrhoea-associated HUS is described as a multiorgan entity, due to extensive microvascular damage and thrombosis. At present mortality during the acute phase is not confined to renal failure; systemic involvement can also lead to death.

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References

  1. Gasser C, Gauthier E, Steck A, Siebenman, RE, Dechslin R (1955) Hämolytisch-urämische Syndrome: bilaterale Nierenrindennekrosen bei akuten, erworbenen hämolytischen Anämien. Schweiz Med Wochenschr 38: 905–909

    Google Scholar 

  2. Habib R, Mathieu H, Royer P (1967) Le syndrome hémolytique et urémique de l'enfant. Aspects cliniques et anatomiques dans 27 observations. Nephron 4: 139–150

    PubMed  Google Scholar 

  3. Gianantonio CA, Vitacco M, Mendilaharzu F, Gallo GE (1973) The hemolytic-uremic syndrome. Nephron 11: 174–192

    PubMed  Google Scholar 

  4. Karmali MA, Petric M, Lim C, Fleming PC, Arbus GS, Lior H (1985) The association between idiopathic hemolytic-uremic syndrome and infection by verotoxin-producingEscherichia coli. J Infect Dis 151: 619–620

    Google Scholar 

  5. Gianantonio CA (1984) Extrarenal manifestations of the hemolytic-uremic syndrome. In: Strauss J (ed) Acute renal disorders and renal emergencies. Nijhoff, Boston, pp 43–50

    Google Scholar 

  6. Gallo GE, Mendilaharzu F, Delgado N (1994) Sindrome urémicohemolítico: estudio clínico-anatómico en 59 pacientes. Medicina Infantil (B Aires) 1: 178–184

    Google Scholar 

  7. Upadhyaya K, Barwick K, Fishaut M, Kasgarian M, Siegel NJ (1980) The importance of nonrenal involvement in hemolyticuremic syndrome. Pediatrics 65: 115–120

    PubMed  Google Scholar 

  8. Richardson SE, Karmali MA, Becker LE, Smith CR (1988) The histopathology of the hemolytic-uremic syndrome associated with verocytotoxin-producingEscherichia coli infections. Hum Pathol 19: 1102–1108

    PubMed  Google Scholar 

  9. Argyle JC, Hogg RJ, Pysher TJ, Silva FG, Siegler RL (1990) A clinicopathological study of 24 children with hemolytic uremic syndrome. A report of the Southwest Pediatric Nephrology Study Group. Pediatr Nephrol 4: 52–58

    PubMed  Google Scholar 

  10. Gianantonio CA, Vitacco M, Mendilaharzu F, Rutty A, Mendilaharzu J (1964) The hemolytic-uremic syndrome. J Pediatr 64: 478–484

    PubMed  Google Scholar 

  11. Whitington PF, Friedman AL, Chesney RW (1979) Gastrointestinal disease in the hemolytic-uremic syndrome. Gastroenterology 76: 728–733

    PubMed  Google Scholar 

  12. De La Hunt MN, Morris KP, Coulthard MG, Rangecroft L (1991) Oesophageal and severe gut involvement in the haemolytic-uraemic syndrome. Br J Surg 78: 1469–1472

    PubMed  Google Scholar 

  13. Lopez EL, Devoto S, Fayad A, Cánepa C, Morrow AL, Cleary TG (1992) Association between severity of gastrointestinal prodrome and long-term prognosis in classic hemolytic-uremic syndrome. J Pediatr 120: 210–215

    PubMed  Google Scholar 

  14. Sawaf H, Sharp MJ, Youn KJ, Jewell PA, Rabbani A (1978) Ischemic colitis and stricture after hemolytic-uremic syndrome. Pediatrics 61: 315–317

    PubMed  Google Scholar 

  15. Tochen ML, Campbell TR (1977) Colitis in children with the hemolytic-uremic syndrome. J Pediatr Surg 12: 213–219

    PubMed  Google Scholar 

  16. Rooney N, Variend S, Taitz LS (1988) Haemolytic uraemic syndrome and pseudomembranous colitis Pediatr Nephrol 2: 415–418

    PubMed  Google Scholar 

  17. Sunn CCJ, Hill JL, Coombs JW (1983) Hemolytic-uremic syndrome mimicking intestinal intussusception. Pediatr Pathol 1: 415–422

    PubMed  Google Scholar 

  18. Burns JC, Berman ER, Fagre JL, Shikes RH, Lum GM (1982) Pancreatic islet cell necrosis: association with the hemolytic-uremic syndrome. J Pediatr 100: 582–584

    PubMed  Google Scholar 

  19. Andreoli SP, Bergstein JM (1982) Development of insulin-dependent diabetes mellitus during the hemolytic-uremic syndrome. J Pediatr 100: 541–545

    PubMed  Google Scholar 

  20. Van Rhijn A, Donckerwolcke RA, Kuijten RH, Van der Heiden C (1977) Liver damage in the hemolytic-uremic syndrome. Helv Paediatr Acta 32: 77–81

    PubMed  Google Scholar 

  21. Robson WL, Lenng AK, ÑLemay MD, Patino RE (1993) Parotitis in diarrhea-associated hemolytic-uremic syndrome. Pediatr Infect Dis J 12: 257–258

    PubMed  Google Scholar 

  22. Poulton J, Taylor C, De Giovanni J (1987) Dilated cardiomyopathy associated with the haemolytic-uraemic syndrome. Br Heart J 57: 181–187

    PubMed  Google Scholar 

  23. Siegler RL, Brewer ED, Swartz M (1988) Ocular involvement in hemolytic-uremic syndrome. J Pediatr 112: 594–597

    PubMed  Google Scholar 

  24. Bale JF, Brasher C, Siegler RL (1980) Central nervous system manifestations of the hemolytic-uremic syndrome. Am J Dis Child 134: 869–872

    PubMed  Google Scholar 

  25. Schlieper A, Rowe PC, Orrbine E, Zoubek M, Clarck W, Wolfish N, McLaine PN (1992) Sequelae of haemolytic-uraemic syndrome. Arch Dis Child 67: 930–934

    PubMed  Google Scholar 

  26. Trevathan E, Dooling EC (1987) Large thrombotic strokes in hemolytic-uremic syndrome. J Pediatr 111: 863–865

    PubMed  Google Scholar 

  27. Hahn JS, Havens PL, Higgins JJ, O'Rourke PP, Estroff JA, Strand R (1989) Neurological complications of the hemolytic-uremic syndrome. J Child Neurol 4: 108–113

    PubMed  Google Scholar 

  28. Ramírez J, Zgaib S, De Miguel R, Ferrario J, Pérsico R, Da Graca IZ, Gianantonio CA (1989) Actividad de la creatina kinasa y sus isoenzimas en el sindrome urémico-hemolítico. Medicina (B Aires) 49: 285–292

    Google Scholar 

  29. Andreoli SP, Bergstein JM (1983) Acute rhabdomyolysis associated with the hemolytic-uremic syndrome. J Pediatr 103: 78–80

    PubMed  Google Scholar 

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Gallo, G.E., Gianantonio, C.A. Extrarenal involvement in diarrhoea-associated haemolytic-uraemic syndrome. Pediatr Nephrol 9, 117–119 (1995). https://doi.org/10.1007/BF00858990

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  • DOI: https://doi.org/10.1007/BF00858990

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