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Hemolytic-uremic syndrome in Switzerland: a nationwide surveillance 1997-2003

Schifferli, Alexandra ; von Vigier, Rodo ; Fontana, Matteo ; Spartà, Giuseppina ; Schmid, Hans ; Bianchetti, Mario ; Rudin, Christoph

In: European Journal of Pediatrics, 2010, vol. 169, no. 5, p. 591-598

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    Titre
    • Hemolytic-uremic syndrome in Switzerland: a nationwide surveillance 1997-2003
    Auteur
    • Schifferli, Alexandra. University Children's Hospital UKBB, Roemergasse, 8, CH4058, Basel, Switzerland
    • von Vigier, Rodo. University Children's Hospital, Berne, Switzerland
    • Fontana, Matteo. University Children's Hospital UKBB, Roemergasse, 8, CH4058, Basel, Switzerland
    • Spartà, Giuseppina. University Children's Hospital, Zurich, Switzerland
    • Schmid, Hans. Federal Office of Public Health (FOPH), Berne, Switzerland
    • Bianchetti, Mario. Division of Pediatrics, Ospedale San Giovanni, Bellinzona, Switzerland
    • Rudin, Christoph. University Children's Hospital UKBB, Roemergasse, 8, CH4058, Basel, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Pediatrics, 2010, vol. 169, no. 5, p. 591-598. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:315648
    Summary
    Hemolytic-uremic syndrome (HUS) is a leading cause of acute renal failure in childhood. In its typical presentation, it is preceded by an episode of diarrhea mostly due to Shiga-toxin-producing Escherichia coli. There is important geographical variation of many aspects of this syndrome. Nationwide data on childhood HUS in Switzerland have not been available so far. In a prospective national study through the Swiss Pediatric Surveillance Unit 114 cases (median age 21months, 50% boys) were reported between April 1997 and March 2003 by 38 pediatric units (annual incidence 1.42 per 105 children ≤16years). Shiga-toxin-producing E. coli were isolated in 32 (60%) of tested stool samples, serotype O157:H7 in eight. Sixteen children presented with only minimal renal involvement, including three with underlying urinary tract infection. Six patients presented with atypical hemolytic-uremic syndrome, and six with HUS due to invasive Streptococcus pneumoniae infection. Mortality was 5.3%, including two out of six children with S. pneumoniae infection. The severity of thrombocytopenia and the presence of central nervous system involvement significantly correlated with mortality. In conclusion, childhood HUS is not rare in Switzerland. Contrasting other countries, E. coli O157:H7 play only a minor role in the etiology. Incomplete manifestation is not uncommon