Outcame of Cases With Hemolytic Uremic Syndrome Attending Assiut University Child Hospital
Outcame of Cases With Hemolytic Uremic Syndrome Attending Assiut University Child Hospital
Diarrhea-associated hemolytic uremic syndrome (D+HUS) is defined as a prodrome of enteritis
 followed by thrombocytopenia (< 150,000/mm3), microangiopathic hemolytic anemia, and signs of
 variable degrees of renal damage (increase in serum Cr, proteinuria, and/or hematuria) . Our
 aim is to detect the most reliable early predictors of poor prognosis to identify children at
 major risk of bad outcome who could eventually benefit from early specific treatments.
The disease is caused predominantly by Shiga toxin-producing enterohemorrhagic Escherichia
 coli (STEC) and is one of the most common etiologies of acute kidney injury (AKI) and an
 important cause of acquired chronic kidney disease in children [2]. The incidence of HUC
 tends to parallel the seasonal fluctuation of E.coli o175 : H7 infection which peaks between
 June & September. Nowadays, the incidence increases and is typically observe in infants and
 children, especially those aged 6 months to 4 years. A complicated disease course is defined
 as the development of one or more of the following manifestations: neurological dysfunction,
 severe bowel injury, pancreatitis, hemodynamic instability (symptomatic hypotension,
 multi-organ failure), cardiac (congestive heart failure, myocarditis, pericarditis,
 arrhythmia) or pulmonary involvement (pulmonary edema, acute respiratory distress syndrome),
 hematologic complications (hemorrhage), and death [1].

 Many laboratory and clinical markers upon admission have been associated to severe forms of
 the disease, including high initial leukocyte and hematocrit levels, major extrarenal
 complications, dehydration and recently, the blood urea nitrogen (BUN) to serum creatinine
 (Cr) ratio [1], [4-6]. Treatment of D+HUS remains supportive; thus, early identification of
 high-risk patients can optimize their management [1-3].
Inclusion Criteria:

 -  all patients less than 18 years diagnosed with Hemolytic Uremic Syndrome