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2019, Number 3

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Rev Cubana Pediatr 2019; 91 (3)

Breakthrough in the knowledge on pathogenesis of haemolytic uremic syndrome

Mena MVR, Puig SL

Language: Spanish
References: 22
Page: 1-15
PDF size: 368.62 Kb.


ABSTRACT

The proposed objective is to reorder the knowledge on haemolytic uremic syndrome´s management in pediatricians that have to face the care of patients suffering this disease in emergency services, hospitalization and intensive care units. Nowadays, it is considered a rare or emerging disease. In 90 % of the cases, it is caused mainly by an enteric infection with Escherichia coli which produces Shiga toxine. The infection in humans is provoqued by consumption of raw contamined meat, non-pasteurized milk or dairy products, water, fruits or vegetables. Incubation period after ingestion is of 1 to 10 days. The syndrome’s diagnostic is based in the presence of diarrheic prodome associated to microangiopathic hemolytic anemia; thrombocytopenia and acute renal damage which are elements that characterize the disease. Thrombocytopenia can be transitory and not detected in laboratory tests. Platelets count> 150 000 could be an indirect marker of resolution in the microagniopathic process. Clinically speaking, it normally starts with abdominal pain, diarrhea and evolution in 4 to 10 days of acute renal damage. The current treatment for patients witht the syndrome is supportive treatment although it is also used the recombinant monoclonal antibody called Eculizumab; and also plasma recharge therapies as a front line treatment as soon as the diagnostic has been made. Hemolytic uremic syndrome is one of the main causes of acute renal failure in children. Its diagnostic and early and timely treatment are the key to prevent complications of this entity.


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