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Hemolytic-uremic syndrome in Switzerland: a nationwide surveillance 1997–2003
Hemolytic-uremic syndrome (HUS) is a leading cause of acute renal failure in childhood. In its typical presentation, it is preceded by an episode of diarrhea mostly due to Shiga-toxin-producing Escherichia coli . There is important geographical variation of many aspects of this syndrome. Nationwide...
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Published in: | European journal of pediatrics 2010-05, Vol.169 (5), p.591-598 |
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Main Authors: | , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Hemolytic-uremic syndrome (HUS) is a leading cause of acute renal failure in childhood. In its typical presentation, it is preceded by an episode of diarrhea mostly due to Shiga-toxin-producing
Escherichia coli
. There is important geographical variation of many aspects of this syndrome. Nationwide data on childhood HUS in Switzerland have not been available so far. In a prospective national study through the Swiss Pediatric Surveillance Unit 114 cases (median age 21 months, 50% boys) were reported between April 1997 and March 2003 by 38 pediatric units (annual incidence 1.42 per 10
5
children ≤16 years). Shiga-toxin-producing
E. coli
were isolated in 32 (60%) of tested stool samples, serotype O157:H7 in eight. Sixteen children presented with only minimal renal involvement, including three with underlying urinary tract infection. Six patients presented with atypical hemolytic-uremic syndrome, and six with HUS due to invasive
Streptococcus pneumoniae
infection. Mortality was 5.3%, including two out of six children with
S. pneumoniae
infection. The severity of thrombocytopenia and the presence of central nervous system involvement significantly correlated with mortality. In conclusion, childhood HUS is not rare in Switzerland. Contrasting other countries,
E. coli
O157:H7 play only a minor role in the etiology. Incomplete manifestation is not uncommon. |
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ISSN: | 0340-6199 1432-1076 |
DOI: | 10.1007/s00431-009-1079-9 |