Diarrhea-associated Hemolytic Uremic Syndrome in Southern Alberta: A Long-term Single-centre Experience

Overview

Journal Paediatr Child Health

Publisher Oxford University Press

Specialty Pediatrics

Date 2012 Jun 2

PMID 22654544

Citations 5

Authors

Silviu Grisaru

Julian P Midgley

Lorraine A Hamiwka

Andrew W Wade

Susan M Samuel

Affiliations

Soon will be listed here.

Abstract

Background: Reports of long-term incidence trends of endemic diarrhea-associated hemolytic uremic syndrome (D+HUS) are few and inconclusive.

Objective: To define and analyze the incidence and outcomes of D+HUS over a period of approximately 25 years in a highly endemic region of southern Alberta.

Methods: Annual incidence rates of confirmed cases of D+HUS were compared between two 12-year periods (1980 to 1992 and 1994 to 2006). Differences in therapies used, and some short- and long-term complications observed were also compared between the two periods.

Results: The absolute yearly number of D+HUS cases was highly variable. The comparison between the 1980 to 1992, and 1994 to 2006 periods demonstrated a modest 8.8% decrease in the total number of cases. The population-based average annual incidence rates were not significantly different between the two time periods (3.33 cases versus 2.58 cases per 100,000 population per year, respectively; P=0.30). Only supportive care measures were used in the latter period. A mortality rate of lower than 1% in the latter period was one of the lowest ever reported for a large cohort of D+HUS patients.

Conclusion: The present long-term retrospective study of D+HUS in a highly endemic area documented a modest decrease in the absolute number of cases but no difference in the average annual incidence over an extended period of time.

Citing Articles

Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management.

Travert B, Rafat C, Mariani P, Cointe A, Dossier A, Coppo P Toxins (Basel). 2021; 13(5).

PMID: 33925836 PMC: 8145702. DOI: 10.3390/toxins13050306.

Shiga Toxin-Associated Hemolytic Uremic Syndrome: A Narrative Review.

Joseph A, Cointe A, Mariani Kurkdjian P, Rafat C, Hertig A Toxins (Basel). 2020; 12(2).

PMID: 31973203 PMC: 7076748. DOI: 10.3390/toxins12020067.

Management of hemolytic-uremic syndrome in children.

Grisaru S Int J Nephrol Renovasc Dis. 2014; 7:231-9.

PMID: 24966691 PMC: 4062558. DOI: 10.2147/IJNRD.S41837.

Dexamethasone rescues neurovascular unit integrity from cell damage caused by systemic administration of shiga toxin 2 and lipopolysaccharide in mice motor cortex.

Pinto A, Jacobsen M, Geoghegan P, Cangelosi A, Cejudo M, Tironi-Farinati C PLoS One. 2013; 8(7):e70020.

PMID: 23894578 PMC: 3720947. DOI: 10.1371/journal.pone.0070020.

Long-term outcomes of Shiga toxin hemolytic uremic syndrome.

Spinale J, Ruebner R, Copelovitch L, Kaplan B Pediatr Nephrol. 2013; 28(11):2097-105.

PMID: 23288350 DOI: 10.1007/s00467-012-2383-6.

References

Ochoa T, Cleary T . Epidemiology and spectrum of disease of Escherichia coli O157. Curr Opin Infect Dis. 2003; 16(3):259-63. DOI: 10.1097/00001432-200306000-00013. View

Rogers M, Rutherford G, Alexander S, DiLiberti J, Foster L, Schonberger L . A population-based study of hemolytic-uremic syndrome in Oregon, 1979-1982. Am J Epidemiol. 1986; 123(1):137-42. DOI: 10.1093/oxfordjournals.aje.a114207. View

Garg A, Suri R, Barrowman N, Rehman F, Matsell D, Rosas-Arellano M . Long-term renal prognosis of diarrhea-associated hemolytic uremic syndrome: a systematic review, meta-analysis, and meta-regression. JAMA. 2003; 290(10):1360-70. DOI: 10.1001/jama.290.10.1360. View

Robson W, Leung A, Trevenen C, Brant R . Diarrhea-associated hemolytic uremic syndrome. Can Fam Physician. 1993; 39:2139-45. PMC: 2379856. View

Proulx F, Sockett P . Prospective surveillance of Canadian children with the haemolytic uraemic syndrome. Pediatr Nephrol. 2005; 20(6):786-90. DOI: 10.1007/s00467-005-1843-7. View

Waters J, Sharp J, Dev V . Infection caused by Escherichia coli O157:H7 in Alberta, Canada, and in Scotland: a five-year review, 1987-1991. Clin Infect Dis. 1994; 19(5):834-43. DOI: 10.1093/clinids/19.5.834. View

Rowe P, Orrbine E, Wells G, McLaine P . Epidemiology of hemolytic-uremic syndrome in Canadian children from 1986 to 1988. The Canadian Pediatric Kidney Disease Reference Centre. J Pediatr. 1991; 119(2):218-24. DOI: 10.1016/s0022-3476(05)80730-9. View

Decludt B, Bouvet P, Mariani-Kurkdjian P, Grimont F, Grimont P, Hubert B . Haemolytic uraemic syndrome and Shiga toxin-producing Escherichia coli infection in children in France. The Société de Néphrologie Pédiatrique. Epidemiol Infect. 2000; 124(2):215-20. PMC: 2810903. DOI: 10.1017/s0950268899003623. View

Siegler R, Pavia A, Christofferson R, Milligan M . A 20-year population-based study of postdiarrheal hemolytic uremic syndrome in Utah. Pediatrics. 1994; 94(1):35-40. View

10.

Cummings K, Mohle-Boetani J, Werner S, Vugia D . Population-based trends in pediatric hemolytic uremic syndrome in California, 1994-1999: substantial underreporting and public health implications. Am J Epidemiol. 2002; 155(10):941-8. DOI: 10.1093/aje/155.10.941. View

11.

Haus-Cheymol R, Espie E, Che D, Vaillant V, de Valk H, Desenclos J . Association between indicators of cattle density and incidence of paediatric haemolytic-uraemic syndrome (HUS) in children under 15 years of age in France between 1996 and 2001: an ecological study. Epidemiol Infect. 2005; 134(4):712-8. PMC: 2870442. DOI: 10.1017/S095026880500542X. View

12.

Bitzan M . Treatment options for HUS secondary to Escherichia coli O157:H7. Kidney Int Suppl. 2009; (112):S62-6. DOI: 10.1038/ki.2008.624. View

13.

Tarr P, Neill M, Allen J, Siccardi C, Watkins S, HICKMAN R . The increasing incidence of the hemolytic-uremic syndrome in King County, Washington: lack of evidence for ascertainment bias. Am J Epidemiol. 1989; 129(3):582-6. DOI: 10.1093/oxfordjournals.aje.a115170. View

14.

Lynn R, OBrien S, Taylor C, Adak G, Chart H, Cheasty T . Childhood hemolytic uremic syndrome, United Kingdom and Ireland. Emerg Infect Dis. 2005; 11(4):590-6. PMC: 3320351. DOI: 10.3201/eid1104.040833. View

15.

Karpac C, Lee A, Kunnel B, Bamgbola O, Vesely S, George J . Endemic Esherichia coil O157:H7 infections and hemolytic-uremic syndrome in Oklahoma, 2002-2005. J Okla State Med Assoc. 2008; 100(11):429-33. View

16.

Siegler R, Oakes R . Hemolytic uremic syndrome; pathogenesis, treatment, and outcome. Curr Opin Pediatr. 2005; 17(2):200-4. DOI: 10.1097/01.mop.0000152997.66070.e9. View

17.

. Preliminary FoodNet data on the incidence of infection with pathogens transmitted commonly through food--10 states, 2007. MMWR Morb Mortal Wkly Rep. 2008; 57(14):366-70. View