Document Detail


Timing and utility of ultrasound in diarrhea-associated hemolytic uremic syndrome: 7-year experience of a large tertiary care hospital.
MedLine Citation:
PMID:  20075028     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The authors reviewed the clinical, laboratory, and imaging data from cases of diarrhea-associated hemolytic uremic syndrome (HUS D+), diagnosed at our institution, from 2001 to 2008. The timing and utility of ultrasonographic features of HUS D+ were analyzed. The aim of the study was to determine factors that could aid in the early diagnosis of this disease. A total of 13 children with HUS D+ were identified out of 23 patients with HUS diagnosed during this time period. Evidence of Escherichia coli 0157:H7 was found in 9 cases (70%). Ultrasound studies were ordered in 10 patients (71%), all of which showed renal sonographic findings compatible with HUS. Ultrasound was performed at a mean of 13 days after onset of the diarrhea. Of note, 2 patients whose ultrasounds were performed at the beginning of their diarrheal illness manifested ultrasonographic features suggestive of HUS when there was only a mild increase in serum creatinine and no decrease in hemoglobin or platelets, suggesting that ultrasonography can identify renal involvement early in the course of the disease before other systemic signs appear. Early renal ultrasound may be a useful adjunct in the initial evaluation in children with bloody diarrhea. Evidence of increased renal echogenicity in a patient with bloody diarrhea could aid in early recognition of HUS when other diagnoses such as intussusceptions are being entertained, potentially allowing early intervention.
Authors:
Miguel Glatstein; Elka Miller; Facundo Garcia-Bournissen; Dennis Scolnik
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Publication Detail:
Type:  Journal Article     Date:  2010-01-13
Journal Detail:
Title:  Clinical pediatrics     Volume:  49     ISSN:  1938-2707     ISO Abbreviation:  Clin Pediatr (Phila)     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-28     Completed Date:  2010-09-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372606     Medline TA:  Clin Pediatr (Phila)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  418-21     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatric Emergency Medicine, the Hospital for Sick Children, Toronto, Ontario, Canada. nopasara73@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Child
Child, Preschool
Cohort Studies
Diarrhea / complications*,  drug therapy,  microbiology
Early Diagnosis
Escherichia coli / isolation & purification
Escherichia coli Infections / complications,  diagnosis
Female
Hemolytic-Uremic Syndrome / diagnosis,  etiology*,  ultrasonography*
Hospitals, Public
Humans
Kidney Failure, Acute / diagnosis,  prevention & control*
Male
Ontario
Prognosis
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sex Factors
Ultrasonography, Doppler / utilization*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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