Childhood Hemolytic Uremic Syndrome in Jordan

Kamal F. Akl, Amira T. Masri, Mohamad M. Khashman, Saad H. Samara, Rinad M. Nabulsi


Hemolytic Uremic Syndrome (HUS) is the most common cause of Acute Kidney Injury (AKI) in the developed countries. It consists of Microangiopathic Hemolytic Anemia (MAHA), AKI and thrombocytopenia.

Objective: To review the outcome of childhood Diarrhea-associated Hemolytic Uremic Syndrome (D+HUS) presenting to the pediatric department at Jordan University Hospital (JUH).

Patients and Methods: In this retrospective study we reviewed the medical records of children presenting to JUH between January 1977 and January 2008 with D+HUS.

Results: There were 21 patients (15 girls and 6 boys). Age ranged from 6 months to11 years. 8t children (38%) had Entamoeba histolytica infection. 57% needed peritoneal dialysis. Central nervous system manifestations included drowsiness in 8 patients (38.1%), limb weakness in 2 patients (9.5%), seizures in 9 patients (43%), irritability 3 patients (14%), transient blindness in 2 patients (9.5%), and uremic encephalopathy in 1 patient (4.8%).

Outcome included: complete recovery in 11 patients (52.4%), chronic kidney disease in 6 patients (28.6%), central nervous system deficit in 2 patients, and death in 2 patients (9.5%). There was no correlation between the outcome and the presence of leukocytosis, thrombocytopenia, severity of renal failure, hyponatremia, or hypertension (p< 0.05).

Conclusion: Our data highlights the importance of D+HUS in the pediatric age group. In addition, it emphasizes its manifestations, complications, and outcome.


D+HUS, Entamoeba histolytica, outcome, Jordan

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