Intermediate Follow-up of Pediatric Patients With Hemolytic Uremic Syndrome During the 2011 Outbreak Caused by E. coli O104:H4

Loos S, Aulbert W, Hoppe B, Ahlenstiel-Grunow T, Kranz B, Wahl C, Staude H, Humberg A, Benz K, Krause M, Pohl M, Liebau MC, Schild R, Lemke J, Beringer O, Mueller D, Haertel C, Wigger M, Vester U, Konrad M, Haffner D, Pape L, Oh J, Kemper MJ (2017)

Publication Type: Journal article

Publication year: 2017

Journal

Clinical Infectious Diseases Oxford University Press (OUP): Policy A1 - Oxford Open Option C

Book Volume: 64

Pages Range: 1637-1643

Journal Issue: 12

DOI: 10.1093/cid/cix218

Abstract

Background.: In 2011 Escherichia coli O104:H4 caused an outbreak with >800 cases of hemolytic uremic syndrome (HUS) in Germany, including 90 children. Data on the intermediate outcome in children after HUS due to E. coli O104:H4 have been lacking. Methods.: Follow-up data were gathered retrospectively from the medical records of patients who had been included in the German Pediatric HUS Registry during the 2011 outbreak. Results.: Seventy-two of the 89 (81%) patients were included after a median follow-up of 3.0 (0.9-4.7) years. Hypertension and proteinuria were present in 19% and 28% of these patients, respectively. Of 4 patients with chronic kidney disease (CKD) > stage 2 at short-term follow-up, 1 had a normalized estimated glomerular filtration rate, and 3 (4%) had persistent CKD > stage 2. In 1 of these patients, CKD improved from stage 4 to 3; 1 who had CKD stage 5 at presentation received kidney transplantation; and 1 patient required further hemodialysis during follow-up. One patient (1.4%) still had major neurological symptoms at the latest follow-up. Dialysis during the acute phase (P = .01), dialysis duration (P = .01), and the duration of oligo-/anuria (P = .005) were associated with the development of renal sequelae. Patients treated with eculizumab (n = 11) and/or plasmapheresis (n = 13) during the acute phase of HUS had comparable outcomes. Conclusions.: The overall outcome of pediatric patients after HUS due to E. coli O104:H4 was equivalent to previous reports on HUS due to other types of Shiga toxin-producing E. coli (STEC). Regular follow-up visits in patients are recommended after STEC-HUS.

Authors with CRIS profile

Kerstin Benz Medizinische Fakultät

Additional Organisation(s)

Department of Paediatrics and Adolescent Medicine

Involved external institutions

Universitätsklinikum Münster DE Germany (DE) Universitätsmedizin Rostock DE Germany (DE) Universität zu Köln DE Germany (DE) Universitätsklinikum Ulm DE Germany (DE) Universitätsklinikum Freiburg DE Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Universitätsklinikum Essen DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) DE Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE)

How to cite

APA:

Loos, S., Aulbert, W., Hoppe, B., Ahlenstiel-Grunow, T., Kranz, B., Wahl, C.,... Kemper, M.J. (2017). Intermediate Follow-up of Pediatric Patients With Hemolytic Uremic Syndrome During the 2011 Outbreak Caused by E. coli O104:H4. Clinical Infectious Diseases, 64(12), 1637-1643. https://doi.org/10.1093/cid/cix218

MLA:

Loos, Sebastian, et al. "Intermediate Follow-up of Pediatric Patients With Hemolytic Uremic Syndrome During the 2011 Outbreak Caused by E. coli O104:H4." Clinical Infectious Diseases 64.12 (2017): 1637-1643.

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