YILDIRIM, Zeynep Yürük İstanbul Üniversitesi - İstanbul Tıp Fakültesi - Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Nefroloji Bilim Dalı, Turkey , YILMAZ, Alev İstanbul Üniversitesi - İstanbul Tıp Fakültesi - Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Nefroloji Bilim Dalı, Turkey , YAVAŞ AKSU, Bağdagül İstanbul Üniversitesi - İstanbul Tıp Fakültesi - Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Nefroloji Bilim Dalı, Turkey , ŞIK, Güntülü Sare İstanbul Üniversitesi - İstanbul Tıp Fakültesi - Çocuk Yoğun Bakım Bilim Dalı, Turkey , BİLGE, Ilmay İstanbul Üniversitesi - İstanbul Tıp Fakültesi - Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Nefroloji Bilim Dalı, Turkey , ÇITAK, Agop İstanbul Üniversitesi - İstanbul Tıp Fakültesi - Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Nefroloji Bilim Dalı, Turkey , EMRE, Sevinç İstanbul Üniversitesi - İstanbul Tıp Fakültesi - Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Çocuk Nefroloji Bilim Dalı, Turkey

CLINICAL COURSE OF DIARRHEA PRECEDING HEMOLYTIC UREMIC SYNDROME CASES

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Objective: Hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The most common form of HUS in children is Shigatoxin-producing Escherichia coli (STEC) related HUS. HUS is the most common causeof acute renal failure in Europe whereas it was not observed in the same frequency in our country. However, in 2011, after the outbreak of Escherichia coli (E. Coli) gastroenteritis and HUS in Germany, we observed significantly increased cases of HUS in our country. In this retrospective study, we aimed to determine the clinical features and prognosis of HUS patients who admitted with a history of diarrhea during this breakout.MaterialsandMethods: We followed up 9 patients with diarrhea associated HUS in 2011. Blood cell count, peripheral blood smear, serum urea, creatinine, electrolytes, complement C3, direct Coombs test, cultures of urine as well as blood and stool, chest X-ray were performed.Results: The mean age was 5.8 ± 4.2 years (3 months-12 years). Six of the patients had complete anuria, the first urine appeared 2-7 days after the presentation. Mean duration of hospitalization was 17.66±13.77 days (8-52). In healing process, first platelet count increased. Urine out put appeared soon after the platelet count rose in the anuric patients, mean duration of anuria and oliguria were 7±3 days (3-10) and 4±5 days (1-14), respectively. Conclusion: The results of our study indicate that it may be appropriate to accept as atypical HUS and treat the patients with low C3 levels, vital organ involvement, long-term renal failure and negative stool tests for verotoxin though it cannot be confirmed at the time of admission

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Hemolytic uremic syndrome , HUS , child

Journal Of Istanbul Faculty Of Medicine

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