Abstract
Although leukocytosis is a prominent feature of HUS, an elevated leukocyte count has not been recognized as an important feature of this syndrome. Ten consecutive patients with HUS admitted to our Hospital were studied. During the acute phase, the highest serum BUN was 101 ± 42 mg/dl and creatinine 4.9 ± 2.6 mg/di. Total leukocyte count was at 16600 ± 5300/ul with differential counts of polymorphonuclear leukocytes at 54 ± 16%, band neutrophils 8 ± 5%, lymphocytes 31 ± 16% and monocytes 6 ± 5%. The role of leukocytes in this syndrome was studied in our model of HUS (J Lab Clin Med 102: 847, 1983) in rabbits given a single intravenous dose of endotoxin (LPS) over 5 hours. Leukocyte functions were studied with assessments of plasma and leukocyte B-glucuronidase (primary granules), plasma and leukocyte lysozyme (secondary granules), chemotaxis, C5a mediated leukocyte aggregation and leukocyte procoagulant contents. Our results showed elevated plasma levels and reduced leukocyte contents of enzymes immediately following LPS infusion. Similarly, leukocyte reactivities plummeted at the same time period. At the time of the striking leukocytosis noted at 24 hours, plasma enzymes, leukocyte enzymes and leukocyte reactivities returned to normal values. At this time, leukocytes were found to have exaggerated amounts of cytoplasmic procoagulants. By day 2, both leukocytosis and procoagulant contents returned to normal.
We conclude that leukocytosis is a common feature of various forms of HUS. Perturbation of leukocytes may play a role in and also reflect the process of inflammatory injury in this syndrome.
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Vedanarayanan, V., Kaplan, B. & Fong, J. 1648 LEUKOCYTES IN CLINICAL AND EXPERIMENTAL HEMOLYTIC UREMIC SYNDROME (HUS). Pediatr Res 19, 385 (1985). https://doi.org/10.1203/00006450-198504000-01672
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DOI: https://doi.org/10.1203/00006450-198504000-01672