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Incidence and index of severity of hemolytic uremic syndrome in a 26 year period in F ukushima Prefecture, J apan
Author(s) -
Kawasaki Yukihiko,
Suyama Kazuhide,
Maeda Ryo,
Yugeta Eichi,
Takano Kei,
Suzuki Shigeo,
Sakuma Hiroko,
Nemoto Kenji,
Sato Tomoko,
Nagasawa Katsutoshi,
Hosoya Mitsuaki
Publication year - 2014
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12193
Subject(s) - medicine , incidence (geometry) , index (typography) , period (music) , pediatrics , physics , optics , world wide web , computer science , acoustics
Abstract Background There have been a number of reports on large outbreaks of hemolytic uremic syndrome ( HUS ), but there have been no long‐term studies of sporadic HUS in J apan. This study therefore investigated the epidemiology and prognosis of HUS in F ukushima Prefecture over a 26 year period. Methods The medical records of 26 patients with HUS between 1987 and 2012 were collected. These children were divided into two groups: those with HUS following an episode of gastroenteritis, often with bloody diarrhea ( D + HUS ; n = 24) and those with HUS not associated with prodromal diarrhea ( D–HUS ; n = 2). The D + HUS group was further subdivided into group A (11 patients requiring dialysis) and group B (13 patients not requiring dialysis). The epidemiological and clinical data, as well as prognosis, were retrospectively investigated for each group. Results Approximately 90% of HUS patients belonged to the D + HUS group. In this group, the mean number of patients per year from 1987 to 1999, and from 2000 to 2012 was 0.92 ± 0.95, and 1.08 ± 0.86, respectively. On admission, lactate dehydrogenase ( LDH ), alanine aminotransferase ( ALT ), blood urea nitrogen ( BUN ), serum creatinine and serum fibrinogen degradation product ( FDP ) levels in group A were all higher than in group B . Serum albumin level and estimated glomerular filtration rate (e GFR ) in group A were lower than in group B . At 6 months after the onset of HUS in the D + HUS group, renal function was normal. Conclusions The frequency of HUS was constant from 1987 to 2012 in Fukushima. and serum LDH , ALT , BUN , creatinine, and FDP levels as well as e GFR might be risk factors for dialysis in D + HUS children.