Shiga toxin-associated hemolytic uremic syndrome complicated by intestinal perforation in a child with typical hemolytic uremic syndrome.
- Author:
Hye Jin CHANG
1
;
Hwa Young KIM
;
Jae Hong CHOI
;
Hyun Jin CHOI
;
Jae Sung KO
;
Il Soo HA
;
Hae Il CHEONG
;
Yong CHOI
;
Hee Gyung KANG
Author Information
- Publication Type:Case Report
- Keywords: Intestinal perforation; Hemolytic uremic syndrome; Shiga toxin; Typical
- MeSH: Acute Kidney Injury; Anemia, Hemolytic; Child*; Colitis; Colon; Enteritis; Enterohemorrhagic Escherichia coli; Escherichia coli; Hemolytic-Uremic Syndrome*; Humans; Incidence; Intestinal Perforation*; Intussusception; Necrosis; Peritonitis; Rectal Prolapse; Renal Insufficiency; Renal Replacement Therapy; Shiga Toxin; Thrombocytopenia
- From:Korean Journal of Pediatrics 2014;57(2):96-99
- CountryRepublic of Korea
- Language:English
- Abstract: Hemolytic uremic syndrome (HUS) is one of the most common causes of acute renal failure in childhood and is primarily diagnosed in up to 4.5% of children who undergo chronic renal replacement therapy. Escherichia coli serotype O157:H7 is the predominant bacterial strain identified in patients with HUS; more than 100 types of Shiga toxin-producing enterohemorrhagic E. coli (EHEC) subtypes have also been isolated. The typical HUS manifestations are microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency. In typical HUS cases, more serious EHEC manifestations include severe hemorrhagic colitis, bowel necrosis and perforation, rectal prolapse, peritonitis, and intussusceptions. Colonic perforation, which has an incidence of 1%-2%, can be a fatal complication. In this study, we report a typical Shiga toxin-associated HUS case complicated by small intestinal perforation with refractory peritonitis that was possibly because of ischemic enteritis. Although the degree of renal damage is the main concern in HUS, extrarenal complications should also be considered in severe cases, as presented in our case.
