Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT: BACKGROUND: Hemolytic uremic syndrome is the most common cause of acute renal failure in children and has high mortality rate. OBJECTIVE: To study the epidemiology, clinical course, management, complications and the important risk factors that affect the outcome of the patients with hemolytic uremic syndrome. PATIENTS AND METHOD: In this retrospective study we collect fifty two patients who were admitted to the Child´s Central Teaching Hospital from the period 1st of Jan. 2005 till 30th May 2008. The data collected from the case records includes: name, sex, age, season, presence of diarrhea, jaundice, family history of HUS, complications, associated clinical features such as: pallor, edema, rash, hypertension, hepatosplenomegaly, and coarse of the disease. Also Laboratory. Findings as Haemlglobin (Hb), Packet Cell Volume (PCV)%, White Blood Cell (WBC), Red Blood Cell (RBC) morphology, platelets counts, blood urea and serum creatinine; and managements were included in the study. RESULTS: Of total 52 , there were 21 (40.4%) cases below 2 years, the males account 33 (63.46%) from the total. There were seasonal and annual increments. Eighty four percent had diarrheal prodrome, and 1.91% had familial history of HUS. All patients had pallor and acute renal failure. The mean of the hemoglobin was 8.6 gm/dl, WBC count mean was 18 × 109/L, platelets mean was 35 × 109/L, blood urea mean was 180 mg/dl, and the mean of serum creatinine was 3.8 mg/dl. The GIT complications was the commonest 23 (44.23%) followed by CNS complication 16 (30.7%), hypertension was present in 25%. During acute phase of disease 12 (23.07%) patients died. CONCLUSION: HUS affect mainly age between 3 months and 4 years. There was seasonal variation with peak at wormer months.There were statistically significance correlation between high risk patients and age group below 2 years, CNS complication, and non diarrheal prodrome.