[Hemolytic-uremic syndrome in children. Review of nine cases]

Nine cases of hemolytic uraemic syndrome diagnosed in a single institution during the last eight years are reviewed. In two cases the prodromic phase was rather dramatic and, the disease itself was apparently triggered by streptococcal infections (S. haemolyticus of group C in one case and S. "Agalactiae" in another one). Interestingly enough, one patient with familiar haemolytic uraemic syndrome showed hypocomplementaemia. Complement levels were also low in another patient. In seven out of nine cases, a histopathologic study of the kidney was carried out showing micro angiopathy predominantly glomerular (five cases), microangiopathy predominantly arterial (one case) and cortical necrosis (one case). A fairly good correlation between the histopathological changes and the clinical outcome has been observed in the only case with long-term sequelae who has predominantly vascular microangiopathy. With respect to the therapy, efficacy of the inhibitor of the angiotensin converting enzyme in a case in which severe arterial hypertension appeared, is emphasized.