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. 1999 Mar;80(3):214–220. doi: 10.1136/adc.80.3.214

Neuropsychological sequelae of haemolytic uraemic syndrome

A Schlieper 1, E Orrbine 1, G Wells 1, M Clulow 1, P McLaine 1, P Rowe 1
PMCID: PMC1717871  PMID: 10325699

Abstract

BACKGROUND—Severe haemolytic uraemic syndrome (HUS) in childhood can cause stroke, hemiplegia, cortical blindness, and psychomotor retardation. These outcomes are evident at the time of discharge immediately after the acute illness. Less is known about the neuropsychological outcomes of less severely affected children who recover from acute HUS.
AIMS—This multicentre case control study investigated the hypothesis that children who survive an acute episode of HUS without recognisable neurological injuries have greater impairment of cognitive, academic, and behavioural functions than controls.
DESIGN—Children with HUS were eligible if they had no evidence of severe neurological dysfunction when discharged from one of six Canadian hospitals. Controls had been admitted to hospital for a non-HUS illness and were matched by age, sex, first language, and socioeconomic status. All subjects underwent evaluation of behaviour, academic achievement, cognitive function, and verbal abilities using standardised tests administered by a psychometrist blinded to the case or control status.
RESULTS—Ninety one case control pairs were enrolled. No important differences between patients with HUS and paired controls were evident on tests of IQ, behaviour, verbal abilities, or academic achievement. There was no increased risk of attention deficit disorder among patients with HUS. There was no correlation between the severity of acute renal failure and neuropsychological measures, although scores on some verbal ability tests were lower in those with the highest serum creatinine concentrations during illness.
CONCLUSIONS—Children discharged from hospital without apparent neurological injury after an episode of acute HUS do not have an increased risk of subclinical problems with learning, behaviour, or attention.



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Selected References

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  1. Bale J. F., Jr, Brasher C., Siegler R. L. CNS manifestations of the hemolytic-uremic syndrome. Relationship to metabolic alterations and prognosis. Am J Dis Child. 1980 Sep;134(9):869–872. doi: 10.1001/archpedi.1980.02130210053014. [DOI] [PubMed] [Google Scholar]
  2. Fennell R. S., Fennell E. B., Carter R. L., Mings E. L., Klausner A. B., Hurst J. R. A longitudinal study of the cognitive function of children with renal failure. Pediatr Nephrol. 1990 Jan;4(1):11–15. doi: 10.1007/BF00858429. [DOI] [PubMed] [Google Scholar]
  3. GASSER C., GAUTIER E., STECK A., SIEBENMANN R. E., OECHSLIN R. Hämolytisch-urämische Syndrome: bilaterale Nierenrindennekrosen bei akuten erworbenen hämolytischen Anämien. Schweiz Med Wochenschr. 1955 Sep 20;85(38-39):905–909. [PubMed] [Google Scholar]
  4. GIANANTONIO C., VITACCO M., MENDILAHARZU F., RUTTY A., MENDILAHARZU J. THE HEMOLYTIC-UREMIC SYNDROME. J Pediatr. 1964 Apr;64:478–491. doi: 10.1016/s0022-3476(64)80337-1. [DOI] [PubMed] [Google Scholar]
  5. Gianantonio C. A., Vitacco M., Mendilaharzu F., Gallo G. E., Sojo E. T. The hemolytic-uremic syndrome. Nephron. 1973;11(2):174–192. doi: 10.1159/000180229. [DOI] [PubMed] [Google Scholar]
  6. Green L. W. Manual for scoring socioeconomic status for research on health behavior. Public Health Rep. 1970 Sep;85(9):815–827. [PMC free article] [PubMed] [Google Scholar]
  7. Hahn J. S., Havens P. L., Higgins J. J., O'Rourke P. P., Estroff J. A., Strand R. Neurological complications of hemolytic-uremic syndrome. J Child Neurol. 1989 Apr;4(2):108–113. doi: 10.1177/088307388900400206. [DOI] [PubMed] [Google Scholar]
  8. Kaplan B. S., Katz J., Krawitz S., Lurie A. An analysis of the results of therapy in 67 cases of the hemolytic-uremic syndrome. J Pediatr. 1971 Mar;78(3):420–425. doi: 10.1016/s0022-3476(71)80221-4. [DOI] [PubMed] [Google Scholar]
  9. Karmali M. A., Steele B. T., Petric M., Lim C. Sporadic cases of haemolytic-uraemic syndrome associated with faecal cytotoxin and cytotoxin-producing Escherichia coli in stools. Lancet. 1983 Mar 19;1(8325):619–620. doi: 10.1016/s0140-6736(83)91795-6. [DOI] [PubMed] [Google Scholar]
  10. Nadwodny R. The growing use of postal codes in health research. Can J Public Health. 1990 May-Jun;81(3):232–233. [PubMed] [Google Scholar]
  11. Qamar I. U., Ohali M., MacGregor D. L., Wasson C., Krekewich K., Marcovitch S., Arbus G. S. Long-term neurological sequelae of hemolytic-uremic syndrome: a preliminary report. Pediatr Nephrol. 1996 Aug;10(4):504–506. doi: 10.1007/s004670050150. [DOI] [PubMed] [Google Scholar]
  12. Quinton D., Rutter M. Early hospital admissions and later disturbances of behaviour: an attempted replication of Douglas' findings. Dev Med Child Neurol. 1976 Aug;18(4):447–459. doi: 10.1111/j.1469-8749.1976.tb03684.x. [DOI] [PubMed] [Google Scholar]
  13. Rooney J. C., Anderson R. M., Hopkins I. J. Clinical and pathological aspects of central nervous system involvement in the haemolytic uraemic syndrome. Aust Paediatr J. 1971 Mar;7(1):28–33. doi: 10.1111/j.1440-1754.1971.tb02465.x. [DOI] [PubMed] [Google Scholar]
  14. Rowe P. C., Orrbine E., Lior H., Wells G. A., Yetisir E., Clulow M., McLaine P. N. Risk of hemolytic uremic syndrome after sporadic Escherichia coli O157:H7 infection: results of a Canadian collaborative study. Investigators of the Canadian Pediatric Kidney Disease Research Center. J Pediatr. 1998 May;132(5):777–782. doi: 10.1016/s0022-3476(98)70303-8. [DOI] [PubMed] [Google Scholar]
  15. Rowe P. C., Orrbine E., Wells G. A., McLaine P. N. Epidemiology of hemolytic-uremic syndrome in Canadian children from 1986 to 1988. The Canadian Pediatric Kidney Disease Reference Centre. J Pediatr. 1991 Aug;119(2):218–224. doi: 10.1016/s0022-3476(05)80730-9. [DOI] [PubMed] [Google Scholar]
  16. Schlieper A., Rowe P. C., Orrbine E., Zoubek M., Clark W., Wolfish N., McLaine P. N. Sequelae of haemolytic uraemic syndrome. Arch Dis Child. 1992 Jul;67(7):930–934. doi: 10.1136/adc.67.7.930. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Shaywitz S. E., Shaywitz B. A., McGraw K., Groll S. Current status of the neuromaturational examination as an index of learning disability. J Pediatr. 1984 Jun;104(6):819–825. doi: 10.1016/s0022-3476(84)80474-6. [DOI] [PubMed] [Google Scholar]
  18. Sheth K. J., Swick H. M., Haworth N. Neurological involvement in hemolytic-uremic syndrome. Ann Neurol. 1986 Jan;19(1):90–93. doi: 10.1002/ana.410190120. [DOI] [PubMed] [Google Scholar]
  19. Steele B. T., Murphy N., Chuang S. H., McGreal D., Arbus G. S. Recovery from prolonged coma in hemolytic uremic syndrome. J Pediatr. 1983 Mar;102(3):402–404. doi: 10.1016/s0022-3476(83)80661-1. [DOI] [PubMed] [Google Scholar]
  20. Trevathan E., Dooling E. C. Large thrombotic strokes in hemolytic-uremic syndrome. J Pediatr. 1987 Dec;111(6 Pt 1):863–866. doi: 10.1016/s0022-3476(87)80207-x. [DOI] [PubMed] [Google Scholar]
  21. Upadhyaya K., Barwick K., Fishaut M., Kashgarian M., Siegel N. J. The importance of nonrenal involvement in hemolytic-uremic syndrome. Pediatrics. 1980 Jan;65(1):115–120. [PubMed] [Google Scholar]

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