Hemolytic uremic syndrome in children - clinical case reports

Abstract

Haemolytic uremic syndrome (HUS) is a rare condition with an increased incidence in children up to 5 years of age (2-3 cases/100000). It is the most common cause of acute renal failure in infants and young children and is characterized by the simultaneous occurrence of the triad: microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The mortality rate of HUS is 5-15% and 12-30% of children are left with long-term sequelae. The diagnosis is most commonly associated with an episode of bloody diarrhea caused by enterohaemorrhagic Shigatoxin-producing Escherichia coli. Early diagnosis and early initiation of renal replacement therapy determine the favorable prognosis of the disease. Purpose was to present clinical cases of children with HUS highlighting the clinical and evolutionary peculiarities. Two clinical cases of patients treated in the Municipal Clinical Hospital of Contagious Diseases for Children, were described. The description of clinical cases reported the evolution of the clinical and paraclinical picture and the stages of diagnosis in childhood HUS. At the same time, it emphasizes the importance of differential diagnosis for the triad composed of microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The approach to the patient in terms of prognostic factors is presented, as well as the particularities of diagnostic as well as therapeutic management. HUS is a severe disease manifested by hemolytic anemia, thrombocytopenia and acute kidney injury, with prognosis determined by the degree of renal damage. Early diagnosis and early initiation of renal replacement therapy is responsible for reducing mortality.