Incidence and index of severity of hemolytic uremic syndrome in a 26 year period in Fukushima Prefecture, Japan
Incidence and index of severity of hemolytic uremic syndrome in a 26 year period in Fukushima Prefecture, Japan
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日本福岛县26年溶血性尿毒症综合征发病率及严重程度指数
DOI：
10.1111/ped.12193
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Hosoya M
中科院分区：
文献类型：
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作者：
Kawasaki Y;Suyama K;Maeda R;Yugeta E;Takano K;Suzuki S;Sakuma H;Nemoto K;Sato T;Nagasawa K;Hosoya M
背景关于溶血性尿毒综合征（HUS）的大规模爆发已有许多报道，但在日本还没有对散发性HUS的长期研究。因此，本研究调查的流行病学和预后的HUS在福岛县超过26 years periods.MethodsThe 26例HUS患者的病历1987年和2012年之间收集。这些儿童被分为两组：HUS在胃肠炎发作后，经常伴有血性腹泻（D + HUS;n= 24）和HUS与前驱腹泻无关（D-HUS;n= 2）。D + HUS组进一步细分为A组（11例需要透析的患者）和B组（13例不需要透析的患者）。流行病学和临床资料，以及预后，进行了回顾性调查，为每个group.ResultsApproximately 90%的HUS患者属于D + HUS组。在该组中，1987年至1999年和2000年至2012年的年平均患者人数分别为0.92 ± 0.95和1.08 ± 0.86。入院时，A组乳酸脱氢酶（LDH）、丙氨酸氨基转移酶（ALT）、血尿素氮（BUN）、血肌酐、血纤维蛋白原降解产物（FDP）水平均高于B组。A组血清白蛋白水平和估计肾小球滤过率（eGFR）低于B组。在发病后6个月的HUS在D + HUS组，肾功能是normal.ConclusionsThe HUS的频率是恒定的，从1987年至2012年在福岛。血清LDH、ALT、BUN、肌酐、FDP水平及eGFR可能是D + HUS患儿透析的危险因素。
BackgroundThere 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 Japan. This study therefore investigated the epidemiology and prognosis of HUS in Fukushima Prefecture over a 26 year period.MethodsThe 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.ResultsApproximately 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 (eGFR) 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.ConclusionsThe frequency of HUS was constant from 1987 to 2012 in Fukushima. and serum LDH, ALT, BUN, creatinine, and FDP levels as well as eGFR might be risk factors for dialysis in D + HUS children.