Haemolytic-uraemic syndrome: clinical experience of an outbreak in the West Midlands.
Haemolytic-uraemic syndrome: clinical experience of an outbreak in the West Midlands.
复制标题
溶血尿毒症综合征：西米德兰兹郡暴发的临床经验。
作者：
C. Taylor;R. White;M. Winterborn;B. Rowe
1982-2003年，来自西米德兰兹郡的35名儿童患上了溶血性尿毒症综合征。这一发病率高于预期，其中包括1983年7月在伍尔弗汉普顿地区发生的一次疫情，两周内有11例病例。23名儿童接受了透析治疗，其中3人死亡。6名患者发展为慢性肾功能衰竭，其中4名患者来自伍尔弗汉普顿。肾外表现包括4例神经后遗症，其中2例还发展为胰岛素依赖型糖尿病和慢性肾功能衰竭。1名儿童发生心肌病，并伴有慢性肾功能衰竭。根据英国以往的经验，这35名患者的预后是无法预测的。这一点，再加上肾外疾病的高流行率和1983年暴发的地理定位，表明该地区存在一种新的病原体。对10名患者的粪便进行了产维罗氏菌毒素检测，并在狼疮暴发期间的3名患者中发现了O157血清型H7阳性菌株。
In 1982-3, 35 children from the West Midlands developed the haemolytic-uraemic syndrome. This was a higher incidence than expected and included an epidemic localised to the Wolverhampton area in July 1983 which comprised 11 cases in two weeks. Twenty three children were treated with dialysis, of whom three died. Six patients developed chronic renal failure, four of them from Wolverhampton. Extrarenal manifestations included neurological sequelae in four, two of whom also developed insulin dependent diabetes mellitus and chronic renal failure. Cardiomyopathy occurred in one child, who also had chronic renal failure. The outcome of these 35 patients was not predictable from prognostic criteria derived from previous experience in Britain. This, together with the high prevalence of extrarenal disease and the geographical localisation of the 1983 outbreak, suggested an aetiological agent new to the region. Faeces from 10 patients were examined for verotoxin producing Escherichia coli, and positive strains of serotype O157.H7 were found in three patients during the Wolverhampton outbreak.