Document Details
Document Type |
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Article In Journal |
Document Title |
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Hemolytic uremic syndrome associated with Streptococcus pneumoniae Hemolytic uremic syndrome associated with Streptococcus pneumoniae |
Subject |
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Paediatrics |
Document Language |
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English |
Abstract |
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The hemolytic uremic syndrome (HUS) is
characterized by the simultaneous occurrence of
the triad of acute renal insufficiency, microangiopathic
hemolytic anemia and thrombocytopenia.
The HUS is the most common cause of acute renal
failure in infants and young children in western
countries. It could be classified into diarrhea
positive, D+ (typical) or diarrhea negative, D-
(atypical) HUS. In Europe and North America, the
typical HUS is the most significant complication of
infection by verocytotoxin (VT) producing
Escherichia coli (VTEC), usually of serotypes O57:
H7. While in some developing countries like
Bangladesh, South Africa, and Zimbabwe, a severer
form of (D+) HUS was reported following Shigella
dysentery. The atypical (D-) HUS has a worse
outcome and could be recurrent. It might be
inherited in an autosomal dominant or recessive
disorder, like factor H deficiency and hypocomplementemia
or associated with other infections
like Streptococcus pneumoniae (S. pneumoniae)1 or
as a complication of using chemotherapy. The (D+)
HUS was described in few studies from the Arab
world.2 Similarly, familial HUS was described in
children from Saudi Arabia,3 Kuwait, and
Bedouin-Arab of Palestine. However, no case of S.
pneumoniae-induced HUS was reported from the
Arab world. The HUS associated with S. pneumoniae
is a rare condition but well described in the
literature as serious disease, which carries an
increased risk of mortality and renal morbidity1,4,5
compared with (D+) HUS. Pediatricians should be
aware that this combination could have devastating
complications in the pediatrics population.
A previously well 4-year-old boy was admitted
with fever and impaired level of consciousness. He
was treated initially with a 3-day course of oral
azithromycin as a case of upper respiratory tract
infection, before his presentation to us. However, he
continued to be febrile and lethargic. On admission,
he was drowsy, blood pressure 113/41 mm Hg,
temperature 38OC, respiratory rate 30/minute and
pulse 138 beats/minute. He looked very sick with
labored breathing |
ISSN |
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16583175 |
Journal Name |
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Saudi Medical Journal |
Volume |
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26 |
Issue Number |
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11 |
Publishing Year |
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1426 AH
2005 AD |
Article Type |
: |
Article |
Added Date |
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Sunday, March 16, 2008 |
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Researchers
| , | Researcher | | |
زاهر زاهر | Zaher, Zaher | Investigator | Doctorate | |
حماد الشايع | Alshaya, Hammad | Researcher | Doctorate | |
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