The hemolytic-uremic syndrome: prognostic significance of neurological abnormalities

To define the prognostic significance of neurological symptoms in the hemolytic-uremic syndrome (HUS), the records of 68 patients with this syndrome were reviewed. Major neurological symptoms (convulsions and/or coma) occurred in 22 patients. Nine of them had dysregulation of breathing as well. An analysis of other symptoms and characteristics of the disease in these 9 patients revealed a rapid progression of the disease, a high incidence of colitis, and a high mortality rate (8 of the 9 patients) despite adequate seizures control, replacement of renal function and assisted ventilation. We conclude that the prognosis of HUS patients with severe neurological symptoms including dysregulation of breathing is poor.