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Neuropediatrics 2017; 48(05): 363-370
DOI: 10.1055/s-0037-1603643
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Neurological Involvement in Pediatric Hemolytic Uremic Syndrome: A Symptom-Oriented Analysis

Sevim Şahin
1   Division of Pediatric Neurology, Department of Pediatrics, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
,
Elif Bahat Özdoğan
2   Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
,
Gülay Kaya
3   Pediatric Intensive Care Unit, Department of Pediatrics, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
,
Nezir Özgün
4   Department of Pediatric Neurology, Diyarbakır Children's Hospital, Diyarbakır, Turkey
,
Ali Cansu
1   Division of Pediatric Neurology, Department of Pediatrics, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
,
Mukaddes Kalyoncu
2   Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
,
Embiya Dilber
5   Department of Pediatrics, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
› Author Affiliations
Further Information

Publication History

01 February 2017

24 April 2017

Publication Date:
01 June 2017 (online)

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Abstract

Background Neurological involvement is common in hemolytic uremic syndrome (HUS), but each neurological symptom may be due to a variety of factors.

Objective We aimed to evaluate predisposing factors to the neurological symptoms in HUS.

Materials and Methods The 10-year follow-up data on HUS patients were retrospectively analyzed. Statistical comparisons were made across subgroups based on age and neurological symptoms.

Results The neurological involvement rate was 37.5%. The female-to-male ratio increased in patients with neurological involvement (3.8 vs. 1.37). Regarding all HUS patients, hemoglobin levels were higher in patients with paresis. The rate of paresis was twofold higher in patients with a hemoglobin level above 11 g/dL (p < 0.05). In diarrhea-associated HUS patients, D-dimer and C-reactive protein levels were higher in patients with paresis, and leukocyte counts were higher in patients with seizures. Patients with altered consciousness had higher creatinine levels. The survival rate was significantly lower in patients with a reticulocyte percentage of less than 2% (50 vs. 100%).

Conclusion Results of our study indicate that neurological involvement depends on overall findings in HUS. A symptom-oriented approach, which is different from that employed in previous studies, reveals some clues to the pathogenesis and management of these patients.

Keywords

hemolytic uremic syndrome - neurological involvement - child - seizure - paresis

Disclosures

The authors state that they have no interests that might be perceived as posing a conflict or bias. They received no financial support for the research, authorship, and/or publication of this article.


 

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