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Journal of the Korean Society of Pediatric Nephrology 2000;4(2): 136-143.
소아 용혈성 요독 증후군 23예에 대한 임상적 고찰
오승진, 육진원, 김지홍, 김병길
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 소아과학교실
3연세대학교 의과대학 소아과학교실
4연세대학교 의과대학 소아과학교실
Clinical Study on Hemolytic Uremic Syndrome in Children: Review of 23 Cases
Seungjin Oh, Jinwon Yook, Ji Hong Kim, Pyung-Kil Kim
1Department of Pediatrics, College of Medicine, Institute of Kidney Disease, Yeungnam University
2Department of Pediatrics, College of Medicine, Institute of Kidney Disease, Yeungnam University
3Department of Pediatrics, College of Medicine, Institute of Kidney Disease, Yeungnam University
4Department of Pediatrics, College of Medicine, Institute of Kidney Disease, Yeungnam University
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ABSTRACT
Purpose : The hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia thrombocytopenia, and acute renal failure. It is ole of tile most common cause of acute renal failure in children but few reports are available in Korea. Thus we investigated the 23 patients diagnosed as HUS during last 14 years. Method : We retrospectively investigated the etiologic factor, clinical manifestations laboratory findings, treatment modalities, and final outcomes of the patients. Then patients were divided into two groups according to outcome, md comparison was performed. Group A(8) comprised patients who progressed to end-stage renal disease or expired. Group B(15) comprised patients who completely recovered after dialysis treatment. Result The number of patients aged less than 4 years were 17; between 5 and 10 were 4 and more than 10 were 2. The gende ratio was M:F=2 : 1. The etiologic factors were as follows: acute gastroenteritis in 14 patients including 4 bloody diarrhea, upper respiratory tract infection in 7 patients, and 1 patient with herbal mediation. The overall mortality rate was 22$%$: 2 patients died of US complications, 2 patients died of sepsis, and 1 patient died of pulmonary hemorrhage. Group A (Hb 4.8${pm}$1.2 g/dL) showed lower value in hemoglobin than group B (Hb 6.3${pm}$1.7 g/dL) during hospital stay (P< 0.05), And the time interval between tile disease onset and dialysis treatment was significantly longer in group A ($11.9{pm}9.1;days;vs;2.8{pm}2.1;days$) (P< 0.05).
Conclusion : Overall mortality rate was 22$%$. Low hemoglobin value and the prolonged time interval between the disease onset and dialysis treatment were related with poor prognosis. So early diagnosis and appropriate intensive care including dialysis treatment is essential to achieve better outcome in children.
Key words: Hemolytic uremic syndrome | Peritoneal dialysis | Acute renal failure
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