Characteristics of hemolytic uremic syndrome in patients from a pediatric hospital in Peru, 2010-2020

Authors

  • Lisbeth Varenia Carrasco-Oros Instituto Nacional de Salud del Niño-Breña, Lima, Perú. Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Perú. https://orcid.org/0000-0003-3926-3310
  • Noé Atamari-Anahui Instituto Nacional de Salud del Niño-Breña, Lima, Perú. Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Perú. https://orcid.org/0000-0001-8283-6669
  • Alcida Goñi-Fano Instituto Nacional de Salud del Niño-Breña, Lima, Perú. Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Perú. https://orcid.org/0000-0003-2584-5547
  • Claudia Sosa-Carmelo Instituto Nacional de Salud del Niño-Breña, Lima, Perú. Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Perú.
  • Eduardo Jesús Guzmán-Quispe Instituto Nacional de Salud del Niño-Breña, Lima, Perú. https://orcid.org/0000-0002-3494-8751
  • Nadin Conto-Palomino Facultad de Medicina Humana, Universidad Nacional Mayor de San Marcos, Lima, Perú. Servicio de pediatría, Hospital Nacional Arzobispo Loayza, Lima, Perú. https://orcid.org/0000-0002-3584-0806
  • Basem Rodolfo Cabrera-Villacriz Instituto Nacional de Salud del Niño-Breña, Lima, Perú. https://orcid.org/0000-0001-7182-9420
  • Carla Lisette Apeña-Cabrera Instituto Nacional de Salud del Niño-Breña, Lima, Perú. https://orcid.org/0009-0003-4642-7309

DOI:

https://doi.org/10.17843/rpmesp.2023.402.12708

Keywords:

Hemolytic uremic syndrome, Renal Replacement Therapy, Child, Peru

Abstract

This study aimed to describe the clinical-epidemiological, laboratory, treatment, and follow-up characteristics of patients with hemolytic uremic syndrome (HUS). The medical records of patients with HUS hospitalized at the Instituto Nacional de Salud del Niño-Breña (INSN-B) (Lima, Peru) were reviewed. We evaluated 83 patients. The median age was 22 months (interquartile range: 14 to 30 months). Of the sample, 71.1% (59) registered previous use of antibiotics. Seventy-two (86.8%) had oligoanuria and 62
(74.6%) had diarrhea. Five cultures were positive (two enterohaemorrhagic Escherichia coli). Forty-nine (59%) required renal replacement therapy. No patient died during hospitalization. At one year of follow-up, seven patients developed post-HUS nephropathy. In conclusion, in INSN-B, the median age was like previous years and there was a higher frequency of oligoanuria, and renal replacement therapy compared to previous reports.

Downloads

Download data is not yet available.

References

Michael M, Bagga A, Sartain SE, Smith RJH. Haemolytic uraemic syndrome. Lancet. 2022;400(10364):1722-40. doi: 10.1016/S0140-6736(22)01202-8.

Ministerio de Salud de Argentina. Boletín epidemiológico nacional N° 630 SE 48 | 2022 [Internet]. 2022 [citado 9 de febrero de 2023]. Disponible en: https://bancos.salud.gob.ar/recurso/boletin-epidemiologico-nacional-n-630-se-48-2022.

Prado JV, Cavagnaro SMF, Grupo de Estudio de Infecciones por STEC. Hemolytic uremic syndrome associated to shigatoxin producing Escherichia coli in Chilean children: clinical and epidemiological aspects. Rev Chil Infectologia. 2008;25(6):435-44. doi: http://dx.doi.org/10.4067/S0716-10182008000600003.

Sakihara G, Mansilla P, Valdivia V, Mendoza A, López V, Pimentel G, et al. Epidemiology and Clinical of Hemolytic Uremic Syndrome (HUS). Analysis of three observation periods. Rev Per Pediatr. 2012;65(3):111-21.

Mansilla P. Clinical and Epidemiological Characteristics of patients with diagnosis of Hemolytic Uremic Syndrome in the Instituto Nacional de Salud del Niño 2002-2009. Rev peru pediatr. 2012;65(3):122-30.

Zambrano OP, Delucchi BA, Cavagnaro SF, Hevia JP, Rosati MP, Lagos RE, et al. Hemolytic-uremic syndrome in Chile: clinical features, evolution and prognostic factors. Rev Med Chil. 2008;136(10):1240-6. doi: 10.4067/S0034-98872008001000002.

Sm FC. Síndrome Hemolítico Urémico asociado a Shigatoxina: ¿Cómo prevenirlo? Rev Chil Pediatría. 2019;90(2):139-44. doi: 10.32641/andespediatr.v90i2.1044.

Boyer O, Niaudet P. Hemolytic-Uremic Syndrome in Children. Pediatr Clin North Am. 2022;69(6):1181-97. doi: 10.1016/j.pcl.2022.07.006.

Vilardouro AS, Cachão J, Rodrigues M, Durão F, Costa-Reis P, Sandes AR, et al. Hemolytic-uremic syndrome: 24 years’ experience of a pediatric nephrology unit. J Bras Nefrol. 2023;45(1):51-9. doi: 10.1590/2175-8239-JBN-2021-0206.

Jenssen GR, Vold L, Hovland E, Bangstad HJ, Nygård K, Bjerre A. Clinical features, therapeutic interventions and long-term aspects of hemolytic-uremic syndrome in Norwegian children: a nationwide retrospective study from 1999-2008. BMC Infect Dis. 2016;16:285. doi: 10.1186/s12879-016-1627-7.

Kakoullis L, Papachristodoulou E, Chra P, Panos G. Shiga toxin-induced haemolytic uraemic syndrome and the role of antibiotics: a global overview. J Infect. 2019;79(2):75-94. doi: 10.1016/j.jinf.2019.05.018.

Tarr PI, Freedman SB. Why antibiotics should not be used to treat Shiga toxin-producing Escherichia coli infections. Curr Opin Gastroenterol. 2022;38(1):30-8. doi: 10.1097/MOG.0000000000000798.

Grisaru S, Xie J, Samuel S, Hartling L, Tarr PI, Schnadower D, et al. Associations Between Hydration Status, Intravenous Fluid Administration, and Outcomes of Patients Infected With Shiga Toxin-Producing Escherichia coli: A Systematic Review and Meta-analysis. JAMA Pediatr. 2017;171(1):68-76. doi: 10.1001/jamapediatrics.2016.2952.

Bilkis MD, Bonany P. Hydration in hemolytic uremic syndrome. Arch Argent Pediatr. 2021;119(1):62-6. doi: 10.5546/aap.2021.eng.62.

Costigan C, Raftery T, Carroll AG, Wildes D, Reynolds C, Cunney R, et al. Neurological involvement in children with hemolytic uremic syndrome. Eur J Pediatr. 2022;181(2):501-12. doi: 10.1007/s00431-021-04200-1.

Netti GS, Santangelo L, Paulucci L, Piscopo G, Torres DD, Carbone V, et al. Low C3 Serum Levels Predict Severe Forms of STEC-HUS With Neurologic Involvement. Front Med. 2020;7:357. doi: 10.3389/fmed.2020.00357.

Rivera F, Ochoa TJ. Escherichia coli productor de toxina Shiga (STEC) en el Perú. Diagnostico. 2013;52(1):23-6.

Coccia PA, Ramírez FB, Suárez ADC, Alconcher LF, Balestracci A, García Chervo LA, et al. Acute peritoneal dialysis, complications and outcomes in 389 children with STEC-HUS: a multicenter experience. Pediatr Nephrol. 2021;36(6):1597-606. doi: 10.1007/s00467-020-04876-x.

Ylinen E, Salmenlinna S, Halkilahti J, Jahnukainen T, Korhonen L, Virkkala T, et al. Hemolytic uremic syndrome caused by Shiga toxin-producing Escherichia coli in children: incidence, risk factors, and clinical outcome. Pediatr Nephrol. 2020;35(9):1749-59. doi: 10.1007/s00467-020-04560-0.

Lulli-Cantoni JA, Miyahira J. Frecuencia de secuela renal pos evento agudo en síndrome urémico hemolítico. Rev Medica Hered. 2015;26(2):86-93.

Published

2023-06-26

Issue

Section

Brief Report

How to Cite

1.
Carrasco-Oros LV, Atamari-Anahui N, Goñi-Fano A, Sosa-Carmelo C, Guzmán-Quispe EJ, Conto-Palomino N, et al. Characteristics of hemolytic uremic syndrome in patients from a pediatric hospital in Peru, 2010-2020. Rev Peru Med Exp Salud Publica [Internet]. 2023 Jun. 26 [cited 2024 Oct. 15];40(2):207-12. Available from: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/12708

Most read articles by the same author(s)