Neurological involvement in children with hemolytic uremic syndrome.

Autor:	Costigan, Caoimhe, Raftery, Tara, Carroll, Anne G., Wildes, Dermot, Reynolds, Claire, Cunney, Robert, Dolan, Niamh, Drew, Richard J., Lynch, Bryan J., O'Rourke, Declan J., Stack, Maria, Sweeney, Clodagh, Shahwan, Amre, Twomey, Eilish, Waldron, Mary, Riordan, Michael, Awan, Atif, Gorman, Kathleen M.
Předmět:	HEMOLYTIC-uremic syndrome THROMBOTIC thrombocytopenic purpura SYMPTOMS CHILDREN'S health MULTIPLE organ failure DISEASE complications THERAPEUTIC use of monoclonal antibodies NEUROLOGICAL disorders ACQUISITION of data methodology BRAIN diseases PLASMA exchange (Therapeutics) CONVALESCENCE RETROSPECTIVE studies TREATMENT effectiveness ESCHERICHIA coli diseases MEDICAL records DESCRIPTIVE statistics SEIZURES (Medicine) DISEASE risk factors CHILDREN
Zdroj:	European Journal of Pediatrics; Feb2022, Vol. 181 Issue 2, p501-512, 12p, 1 Black and White Photograph, 4 Charts
Abstrakt:	Our objective was to establish the rate of neurological involvement in Shiga toxin-producing Escherichia coli–hemolytic uremic syndrome (STEC-HUS) and describe the clinical presentation, management and outcome. A retrospective chart review of children aged ≤ 16 years with STEC-HUS in Children's Health Ireland from 2005 to 2018 was conducted. Laboratory confirmation of STEC infection was required for inclusion. Neurological involvement was defined as encephalopathy, focal neurological deficit, and/or seizure activity. Data on clinical presentation, management, and outcome were collected. We identified 240 children with HUS; 202 had confirmed STEC infection. Neurological involvement occurred in 22 (11%). The most common presentation was seizures (73%). In the neurological group, 19 (86%) were treated with plasma exchange and/or eculizumab. Of the 21 surviving children with neurological involvement, 19 (91%) achieved a complete neurological recovery. A higher proportion of children in the neurological group had renal sequelae (27% vs. 12%, P =.031). One patient died from multi-organ failure. Conclusion: We have identified the rate of neurological involvement in a large cohort of children with STEC-HUS as 11%. Neurological involvement in STEC-HUS is associated with good long-term outcome (complete neurological recovery in 91%) and a low case-fatality rate (4.5%) in our cohort. What is Known: • HUS is associated with neurological involvement in up to 30% of cases. • Neurological involvement has been reported as predictor of poor outcome, with associated increased morbidity and mortality. What is New: • The incidence of neurological involvement in STEC-HUS is 11%. • Neurological involvement is associated with predominantly good long-term outcome (90%) and a reduced case-fatality rate (4.5%) compared to older reports. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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