الفهرس | Only 14 pages are availabe for public view |
Abstract HUS is a multisystem disorder characterized by hemolytic anemia, thrombocytopenia, and ARF and it is one of the most common causes of ARF in young children. HUS has many causes, but in the pediatric age group 90% will be of the post diarrheal variety (D+HUS), due to Stx producing E. coli or other infectious agents (non- E.coli). Moreover, there is another type of cases not associated with diarrhea (D-HUS) representing 10% of cases and labeled as atypical HUS. The aim of this work was to review files of pediatric cases with HUS diagnosed at pediatric department of Tanta University hospital from 2009 to 2019 to identify types of the disease, clinical presentations, prognostic factors and outcome of this disease. This study was conducted retrospectively on the files of all HUS children in pediatric department of Tanta University hospital during this period. It included 68 children; 63 (96.56%) with D+HUS and 5 (7.53%) with D–HUS. The findings of this study in patients with HUS were as follows: • The male to female ratio was 1.19:1. The age of the patients ranged from 0.5 to 13 years, with median (IQR) was 2.25 (5.08). • In this study, 55 patients (89.88%) presented with pallor. diarrhea was observed in 46 cases (67.65%). Oliguria (urine output <1 ml/kg/hr) was present in37 patients (54.41%). Jaundice was noticed in 26 patients (38.24%) while, vomiting was present seen in 20 cases (29.41%) and fever in 17cases (25%). Convulsions were observed in 13 cases (19.21%). Ten patients (14.71%) presented with edema and 8 patients (11.76%) presented with abdominal pain while. petechea was present in 6patients (8.88%). • Since HUS is primarily a clinical diagnosis coupled with consistent laboratory findings, not all the patients underwent renal biopsy and it was done in only 25 patients. • Supportive treatment (early dialysis, red cell transfusion when required, FFP transfusion, fluid restriction, and antihypertensive medications) were the main therapy among those patients. • The outcome of those patients reveled that, the survival rate was 85.29% (58 patients) and the mortality rate was14.71% (10 patients). 37 patients (54.41%) had complete improvement.17 patients (25%) survived but with chronic kidney disease. 4 patients (5.88%) progressed to ESRD and currently maintained on dialysis. |