Abstract
Over the paat several years hemolytic uremic syndrome has been considered an intravascular coagulopathy which is localized to the kidneys. The clinical outcome and histopathologic findings in 12 children who presented with microangiopathic hemolytic anemia, thrombocytopenia, and azotemia are the basis of this report. Renal failure was recognized early and appropriate therapy instituted in all cases. Seven patients recovered completely after a short period of oliguria. Two patients had severe renal failure and required bilateral nephrectomy for control of HBP: both have been transplanted and have normal renal function one and three years later. Three patients died within 8 days of diagnosis: all 3 had been anuric with unresponsive seizures despite early dialysis. Histologic examination in these 3 pts revealed fibrin thrombi and/or infarcts in brain, colon, heart, liver, thyroid, lymph node, and adrenal glands. Ischemic colitis and brain infarcts were notably prevalent.
With early and appropriate therapy for renal failure, the mortality in hemolytic uremic syndrome may be determined by the degree of non-renal involvement, and supportive care may unmask previously unappreciated systemic manifestations of hemolytic uremic syndrome.
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Upadhyaya, K., Berwick, K., Fishaut, M. et al. NON-RENAL INVOLVEMENT IN HEMOLYTIC UREMIC SYNDROME. Pediatr Res 11, 559 (1977). https://doi.org/10.1203/00006450-197704000-01134
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DOI: https://doi.org/10.1203/00006450-197704000-01134