[Clinical presentation and prognostic factors in primary hemolytic-uremic syndrome in adults]

The clinical presentation and prognostic determinants in a group of 20 patients who presented a hemolytic-uremic syndrome for a period of 14 years are reviewed. Patients younger than 10 years old and those with and hemolytic-uremic syndrome due to a systemic disease, renal transplant or accelerated arterial hypertension were excluded from the study. The clinical picture consisted mainly of renal, hematological, hemorrhagic, neurologic cardiovascular, gastrointestinal and hepatic manifestations. It was note worthy the high incidence of malignant hypertension which frequently developed after admission. Thrombocytopenia and hemolysis were frequently not severe and of limited duration. Severe neurologic manifestations was the key determinant of immediate vital prognosis, while severe arterial hypertension was the most reliable marker of irreversible renal failure. In general, the clinical picture was very severe, with and elevated early mortality rate (5 patients) and a high rate of irreversible loss of renal function (five patients needed dialysis, and 4 remained with residual renal failure).