Clinical features and treatment of children with hemolytic uremic syndrome caused by enterohemorrhagic Escherichia coli O157:H7 infection:: Experience of an outbreak in Sakai City, 1996
Clinical features and treatment of children with hemolytic uremic syndrome caused by enterohemorrhagic Escherichia coli O157:H7 infection:: Experience of an outbreak in Sakai City, 1996
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DOI：
10.1046/j.1442-200x.1999.4121039.x
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发表时间：
1999-04-01
影响因子：
1.4
通讯作者：
Moriguchi, N
中科院分区：
文献类型：
--
作者：
Yoshioka, K;Yagi, K;Moriguchi, N
介绍了一项对15例（7男8女，年龄在5 - 10岁之间）溶血性尿毒综合征（HUS）患者的研究，这些患者与1996年7月在酒井市暴发的肠出血性大肠杆菌（EHEC）O 157：H7引起的出血性结肠炎有关。在8名患者中观察到完整形式的HUS，包括溶血性贫血、血小板减少症和急性肾功能不全这三个特征，而在7名患者中观察到不完整形式的HUS，不包括所有三个特征。在治疗方面，9名患者接受静脉注射丙种球蛋白，5名患者（2名男性和3名女性）接受透析治疗。在这5例患者中的3例中，还进行了血浆置换。所有患者在发病第15天完成透析脱机。一些患者出现胰腺炎、中枢神经系统症状、胃底出血和转氨酶升高，尽管这些异常均顺利消退。在两名从急性肾衰竭中恢复但仍有轻度蛋白尿和肌酐清除率降低的患者中进行的肾活检显示肾小球和肾小管中度变化。发病后一年，血液学和泌尿系统的结果在正常范围内的所有患者，除了一个完整的形式的HUS，谁仍然有轻微降低肌酐清除率。
Presented is a study of 15 patients (seven males and eight females ranging between 5 and 10 years of age) with hemolytic uremic syndrome (HUS) associated with hemorrhagic colitis that was caused by enterohemorrhagic Escherichia coli (EHEC) O157:H7, encountered during the outbreak in Sakai City in July, 1996. The complete form of HUS, which includes the three characteristics hemolytic anemia, thrombocytopenia and acute renal dysfunction, was noted in eight patients, while an incomplete form of HUS, which did not include all three characteristics, was noted in seven patients. Regarding treatment, intravenous gamma-globulin was administered in nine patients and dialysis was performed in five patients (two males and three females) with the complete form of HUS. In three of these five patients, plasma exchange was also performed. Weaning from dialysis was accomplished by the 15th day of disease in all patients. Some patients developed pancreatitis, central nervous system symptoms, fundal hemorrhage and elevation of transaminase, although these abnormalities subsided uneventfully. Renal biopsy, which was performed in two patients who recovered from acute renal failure but still had mild proteinuria and a decrease in creatinine clearance, showed moderate changes in the glomeruli and tubulointerstitium. One year after onset of disease, hematological and urological findings were within normal limits in all patients except one with the complete form of HUS, who still had slightly decreased creatinine clearance.