[Cardiac involvement during classic hemolytic uremic syndrome]

Area of Science:

• Pediatric Nephrology
• Cardiology
• Critical Care Medicine

Background:

• Classic hemolytic uremic syndrome (HUS) is primarily characterized by renal failure.
• Cardiac involvement in HUS is uncommon and frequently associated with a fatal outcome.
• Early recognition and management of cardiac complications are crucial for improving patient prognosis.

Observation:

• Three pediatric cases of classic HUS are presented, all requiring peritoneal dialysis.
• Case 1: Myocardial infarction occurred during acute HUS, leading to cardiac necrosis and chronic renal failure.
• Case 2: Dilated cardiomyopathy and cardiac failure developed during acute HUS, with favorable neurological, cardiac, and renal outcomes.
• Case 3: Dilated cardiomyopathy appeared months after HUS resolution, resulting in chronic renal failure and a favorable outcome with medical management.

Findings:

• Cardiac complications, including myocardial infarction and dilated cardiomyopathy, can occur in classic HUS.
• These cardiac events may manifest during the acute phase or several months post-illness.
• Prompt diagnosis and tailored treatment, including dialysis and supportive cardiac care, can lead to favorable outcomes.

Implications:

• Clinicians should actively screen for cardiac involvement in pediatric patients with HUS, both during the acute phase and in the long term.
• Understanding the spectrum of cardiac manifestations in HUS is vital for timely intervention.
• Further research is warranted to elucidate the pathophysiology and optimize management strategies for HUS-associated cardiac complications.