Haemolytic-uraemic Syndrome in Childhood: Surveillance and Case-control Studies in Italy. Italian HUS Study Group

Overview

Journal Pediatr Nephrol

Specialties Nephrology
Pediatrics

Date 1994 Dec 1

PMID 7696109

Citations 11

Authors

A Gianviti

F Rosmini

A Caprioli

R Corona

M C Matteucci

F Principato

I Luzzi

G Rizzoni

Affiliations

Soon will be listed here.

Abstract

Seventy-six cases of haemolytic-uraemic syndrome (HUS) were collected over a 4-year period during a surveillance and case-control study. The annual incidence of 0.2 per 100,000 children aged 0-14 years is lower than in other countries; 34% had no prodromal diarrhoea. Evidence for verocytotoxin-producing Escherichia coli (VTEC) infection was found in 72% of patients and 3% of controls; 88% of patients with bloody diarrhoea, 67% with non-bloody diarrhoea and 55% without diarrhoea were VTEC positive. Seventy-three percent of patients had creatinine clearance > or = 80 ml/min per 1.73 m2, normal blood pressure, no proteinuria and haematuria < 2+ after 1 year of follow-up. One patient died and none had non-renal sequelae. VTEC positivity was significantly correlated with a good outcome, while the absence of diarrhoea and a high total white blood cell count at onset were not predictors of a bad outcome. Household contacts of HUS patients had diarrhoea more frequently than those of the control group, supporting the hypothesis of person-to-person transmission of VTEC infection.

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References

Caprioli A, Luzzi I, Rosmini F, Pasquini P, Cirrincione R, Gianviti A . Hemolytic-uremic syndrome and Vero cytotoxin-producing Escherichia coli infection in Italy. The HUS Italian Study Group. J Infect Dis. 1992; 166(1):154-8. DOI: 10.1093/infdis/166.1.154. View

Coad N, Marshall T, Rowe B, Taylor C . Changes in the postenteropathic form of the hemolytic uremic syndrome in children. Clin Nephrol. 1991; 35(1):10-6. View

Chart H, Rowe B, vd Kar N, Monnens L . Serological identification of Escherichia coli O157 as cause of haemolytic uraemic syndrome in Netherlands. Lancet. 1991; 337(8738):437. DOI: 10.1016/0140-6736(91)91222-g. View

Robson W, Leung A, Fick G, McKenna A . Hypocomplementemia and leukocytosis in diarrhea-associated hemolytic uremic syndrome. Nephron. 1992; 62(3):296-9. DOI: 10.1159/000187063. View

Kaplan B, Proesmans W . The hemolytic uremic syndrome of childhood and its variants. Semin Hematol. 1987; 24(3):148-60. View

Trompeter R, Schwartz R, Chantler C, Dillon M, Haycock G, Kay R . Haemolytic-uraemic syndrome: an analysis of prognostic features. Arch Dis Child. 1983; 58(2):101-5. PMC: 1628096. DOI: 10.1136/adc.58.2.101. View

Rowe P, Orrbine E, Ogborn M, Wells G, Winther W, Lior H . Epidemic Escherichia coli O157:H7 gastroenteritis and hemolytic-uremic syndrome in a Canadian inuit community: intestinal illness in family members as a risk factor. J Pediatr. 1994; 124(1):21-6. DOI: 10.1016/s0022-3476(94)70249-7. View

Loirat C, Sonsino E, Varga Moreno A, Pillion G, Mercier J, Beaufils F . Hemolytic-uremic syndrome: an analysis of the natural history and prognostic features. Acta Paediatr Scand. 1984; 73(4):505-14. DOI: 10.1111/j.1651-2227.1984.tb09962.x. View

Kleanthous H, Smith H, Scotland S, GROSS R, Rowe B, Taylor C . Haemolytic uraemic syndromes in the British Isles, 1985-8: association with verocytotoxin producing Escherichia coli. Part 2: Microbiological aspects. Arch Dis Child. 1990; 65(7):722-7. PMC: 1792459. DOI: 10.1136/adc.65.7.722. View

10.

Caprioli A, Edefonti A, Bacchini M, Luzzi I, Rosmini F, Gianviti A . Isolation in Italy of a verotoxin-producing strain of Escherichia coli O157:H7 from a child with hemolytic-uraemic syndrome. Eur J Epidemiol. 1990; 6(1):102-4. DOI: 10.1007/BF00155561. View

11.

Chart H, Smith H, Scotland S, Rowe B, Milford D, Taylor C . Serological identification of Escherichia coli O157:H7 infection in haemolytic uraemic syndrome. Lancet. 1991; 337(8734):138-40. DOI: 10.1016/0140-6736(91)90801-u. View

12.

Bitzan M, Ludwig K, Klemt M, Konig H, Buren J, Muller-Wiefel D . The role of Escherichia coli O 157 infections in the classical (enteropathic) haemolytic uraemic syndrome: results of a Central European, multicentre study. Epidemiol Infect. 1993; 110(2):183-96. PMC: 2272264. DOI: 10.1017/s0950268800068102. View

13.

Karmali M, Petric M, Lim C, Fleming P, Arbus G, Lior H . The association between idiopathic hemolytic uremic syndrome and infection by verotoxin-producing Escherichia coli. J Infect Dis. 1985; 151(5):775-82. DOI: 10.1093/infdis/151.5.775. View

14.

Martin D, MacDonald K, White K, Soler J, Osterholm M . The epidemiology and clinical aspects of the hemolytic uremic syndrome in Minnesota. N Engl J Med. 1990; 323(17):1161-7. DOI: 10.1056/NEJM199010253231703. View

15.

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

16.

Novillo A, VOYER L, Cravioto R, Freire M, Castano G, Wainstein R . Haemolytic uraemic syndrome associated with faecal cytotoxin and verotoxin neutralizing antibodies. Pediatr Nephrol. 1988; 2(3):288-90. DOI: 10.1007/BF00858679. View

17.

Griffin P, Tauxe R . The epidemiology of infections caused by Escherichia coli O157:H7, other enterohemorrhagic E. coli, and the associated hemolytic uremic syndrome. Epidemiol Rev. 1991; 13:60-98. DOI: 10.1093/oxfordjournals.epirev.a036079. View

18.

Bitzan M, Moebius E, Ludwig K, Muller-Wiefel D, Heesemann J, Karch H . High incidence of serum antibodies to Escherichia coli O157 lipopolysaccharide in children with hemolytic-uremic syndrome. J Pediatr. 1991; 119(3):380-5. DOI: 10.1016/s0022-3476(05)82049-9. View

19.

Lopez E, Diaz M, Devoto S, Grinstein S, Woloj M, Murray B . Evidence of infection with organisms producing Shiga-like toxins in household contacts of children with the hemolytic uremic syndrome. Pediatr Infect Dis J. 1991; 10(1):20-4. DOI: 10.1097/00006454-199101000-00005. View

20.

Neill M, Tarr P, CLAUSEN C, Christie D, HICKMAN R . Escherichia coli O157:H7 as the predominant pathogen associated with the hemolytic uremic syndrome: a prospective study in the Pacific Northwest. Pediatrics. 1987; 80(1):37-40. View