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Hemolytic-uremic syndrome in adolescents
R L Siegler1, A T Pavia, J B Cook
1Division of Nephrology, University of Utah School of Medicine, Salt Lake City, USA.
Archives of Pediatrics & Adolescent Medicine
|February 1, 1997
Summary
Adolescent hemolytic-uremic syndrome (HUS) shares similarities with pediatric HUS in terms of characteristics and outcomes. While the mortality rate was slightly higher in adolescents, long-term renal sequelae were comparable between the groups.
Area of Science:
- Pediatric Nephrology
- Epidemiology
- Clinical Medicine
Background:
- Hemolytic-uremic syndrome (HUS) is a serious condition primarily affecting children.
- Limited data exist comparing HUS in adolescents to younger children.
Purpose of the Study:
- To compare the epidemiological characteristics, clinical features, and outcomes of adolescents with HUS to those of younger children.
Main Methods:
- Retrospective descriptive study utilizing the Utah HUS registry.
- Inclusion of 17 adolescents (12-17 years) and 276 younger patients diagnosed with HUS between 1970 and 1993.
- Analysis of age, sex, seasonality, prodromal diarrhea, laboratory values, hospital course, outcomes, and chronic sequelae.
Main Results:
- Adolescents represented 5.8% of the study population, with similar disease courses to younger children.
- Antecedent diarrhea occurred in ~90% of both groups; laboratory values and hospital courses were comparable.
- Mortality rates were 12% for adolescents and 2.4% for children (P=.09); ~50% in both groups experienced chronic renal sequelae, with similar risks for end-stage renal disease.
Conclusions:
- In the Intermountain West region, adolescent HUS mirrors pediatric HUS.
- The outcome for adolescent HUS is more favorable than for adults.
- Long-term renal sequelae, including hypertension and reduced glomerular filtration, affect approximately 30% of both adolescent and child HUS survivors.
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