[The etiology and clinical features of hemolytic uremic syndrome]

The incidence of hemolytic uremic syndrome (HUS) has been increased for these several years. As the cause of HUS, verotoxin-producing E coli (VTEC) is very important. By our nationwide survey for five years from 1986 to 1990, 146 cases with HUS were compiled. Among 122 cases of HUS, 101 cases (82.8%) had good prognosis, 15 cases (12.3%) had renal or CNS residue. And death rate was 4.9% (6 cases). Clinical features were compared between the groups of good and poor prognosis. In the group of poor prognosis, impaired consciousness, convulsion and hypertension were significantly high. The data of biochemistry such as BUN, creatinine, GOT, GPT, C3, CH50 and CRP were significant between two groups. Demonstration of VTEC and positive serum antibody were seen in 60% among 35 cases. Dr Takeda of National Children's Hospital estimates that the incidence of hemolytic colitis is 1200 cases per year, and the occurrence of HUS is about 100 cases per year, among them 70% cases may be caused by VTEC.