Document Type : Original Article
Authors
1
Department of pediatrics, Faculty of medicine, Zagazig University, Sharkia, Egypt
2
pediatrics, faculty of medicine, zagazig university
3
department of pediatrics, faculty of medicine, Tripoli University, Tripoli. Libya
4
Clinical Pathology department, Faculty of Medicine ; Zagazig University Egypt.
5
Pediatric department, faculty of medicine, Zagazig university, Zagazig, Egypt.
Abstract
Background: The Hemolytic Uremic Syndrome (HUS), a prominent cause of childhood acute kidney injury (AKI) worldwide, includes thrombocytopenia, microangiopathic hemolytic anemia, and AKI as a diagnostic triad; with its post-diarrheal (D+HUS) form being the most common cause. Aim of study: To analyze the clinical characteristics, prognostic factors, and outcomes of children <16 years old with HUS. Patients and methods: This retrospective and prospective cohort study was conducted at nephrology department and Pediatric Intensive Care Unit. It was conducted on 48 children under 16 years old who presented with HUS. Results: The mean value of age was 4.773 ± 3.358 years old, 54.2% of cases were males .60.4% were typical HUS. Complete recovery was more common in typical HUS than atypical HUS (a HUS) (82.7% VS 63.7%) while development of CKD and mortality were more frequent in aHUS (21.1%,15.6%) than typical HUS (6.9%,10.3%) respectively but the difference of no significant value(p=0.536). ROC curve for initial factor H as a predictor for chronicity among atypical HUS patients showed that at cut off level of 0.823, with area under the curve = 0.708; P-value= 0.029 Conclusion: The incidence of typical HUS is higher than a HUS, which occurs more frequently in males than females. A good prognosis was associated with the presentation of diarrhea and oliguria, whereas cough, convulsions, and disturbed consciousness were associated with a poor prognosis. Factor H was found to be a good prognostic marker for the prediction of chronicity in a HUS.
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