ADAMTS-13 level in children with severe diarrhea-associated hemolytic uremic syndrome : unmasking new association

Severe deficiency of ADAMTS-13 leads to thrombotic thrombocytopenic purpura. Few studies have reported reduced activity of ADAMTS-13 in patients with atypical and typical hemolytic uremic syndrome (HUS). We hypothesized that ADAMTS-13 deficiency might play a role in the pathogenesis of severe HUS. T...

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Bibliographic Details
Published in:Saudi journal of kidney diseases and transplantation 2018-03, Vol.29 (2), p.303-309
Main Authors: Mursi, Said M., Tawfiq, Dua M., Khalifah, Nurah A., Khalifah, Najla A., Jawish, Hibah H.
Format: Article
Language:English
Subjects:
Anemia
Blood products
Children
Diarrhea
Disease control
E coli
Enzymes
Health aspects
Health risk assessment
Hemodialysis
Hemolytic-uremic syndrome
Hypertension
Laboratories
Medicine
Mutation
Nephrology
Pathogenesis
Pathology
Pediatrics
Risk factors
Surveillance
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Summary:Severe deficiency of ADAMTS-13 leads to thrombotic thrombocytopenic purpura. Few studies have reported reduced activity of ADAMTS-13 in patients with atypical and typical hemolytic uremic syndrome (HUS). We hypothesized that ADAMTS-13 deficiency might play a role in the pathogenesis of severe HUS. This study aimed to evaluate the ADAMTS-13 level in severe typical HUS. This prospective case–control study was carried out in the Pediatric Nephrology Unit and Clinical Pathology Department, Faculty of Medicine, Zagazig University from February 2013 to February 2014. The study included 15 consecutive children with typical HUS as well as 15 healthy children as a control group. Routine laboratory investigations were performed. Assessment of serum ADAMTS-13 level was performed using the Quantikine human ADAMTS-13 ELISA kit. Data were analyzed using Statistical Package for Social Sciences version 16. Nonparametric values were expressed as median and range, and the median of two groups was tested by Mann–Whitney test. The serum ADAMTS-13 level was significantly lower in HUS patients when compared to the control group (P < 0.05). There were significant negative correlations between ADAMTS-13 level and duration on dialysis, as well as serum urea and creatinine. Furthermore, there were significant positive correlations between serum ADAMTS-13 level and both hemoglobin level and platelet count. Our study suggests that the ADAMTS-13 level was decreased in children with severe typical HUS and its deficiency correlated with disease severity.
ISSN:1319-2442
2320-3838
DOI:10.4103/1319-2442.229262