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Disseminated intravascular coagulation in post-dysenteric haemolytic uraemic syndrome

K G Badami1, R N Srivastava, R Kumar

  • 1Department of Pathology, All India Institute of Medical Sciences, New Delhi.

Acta Paediatrica Scandinavica
|November 1, 1987
PubMed

Insights

Disseminated intravascular coagulation (DIC) is implicated in childhood hemolytic uremic syndrome (HUS) following Shigella dysentery. This study found evidence of DIC and renal cortical necrosis in most affected children.

Area of Science:

  • Pediatrics
  • Nephrology
  • Hematology

Background:

  • Hemolytic uremic syndrome (HUS) is a serious condition in children.
  • Acute dysentery, particularly with Shigella dysenteriae, can precede HUS.
  • The underlying mechanisms of HUS require further elucidation.

Purpose of the Study:

  • To investigate the role of coagulation abnormalities in pediatric HUS.
  • To examine the association between Shigella dysentery and HUS pathogenesis.
  • To evaluate renal pathology in children with HUS.

Main Methods:

  • Coagulation studies were performed on 14 children with HUS.
  • Stool cultures were analyzed for bacterial pathogens.
  • Renal histology was examined to assess the extent of damage.

Main Results:

  • 12 out of 14 children showed evidence of disseminated intravascular coagulation (DIC), indicated by prolonged clotting times and elevated fibrinogen degradation products.
  • Shigella dysenteriae was identified in 3 cases.
  • Renal cortical necrosis was observed in 7 children, with 5 exhibiting extensive damage.

Conclusions:

  • Disseminated intravascular coagulation (DIC) is a significant finding in pediatric HUS following acute dysentery.
  • DIC may play a crucial role in the development of HUS.
  • These findings highlight the complex interplay between infection, coagulation, and renal injury in HUS.

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