Clinical Analysis Of Hemolytic Uremic Syndrome

Objective:To analyze the clinical features and therapy methods of cight cases with hemolytic uremic syndromc(HUS) for improving the diagnosis and therapy of HUS.Methods:The clinical featurcs and therapy of eight patients suffered from HUS were reviewed.They were admitted to the Second College of Shanxi Medical University from 1997 to 2007.Results:There were 8 patients.All the patients suffered from HUS.The subjects included seven adults and one child patients.The ratio of male to female was 2:5.The possible causes included postpartum(three cases),upper respiratory infection(two cases),intestinal infection(one case),upper respiratory combining with intestinal infection(one case).The precursory symptom persistcd on 1 to 8 days before entering the acute stage which the median time was 1.5 days.All patients presentcd the typical characteristics of microangiopathic hemolytic ancmia, thrombocytopenia and acute renal failure.Three patients suffered from fever and five patients had different degrees of central neurological impairment.There were five cases with slight type and three cases with serious type.Renal impairments included oliguresis(one case),anuresis(two cases),gross hematuresis(three cases),hypertension(eight cases) and edema(six cases).All patients were given combined therapy,including general treatments of anti-infection and controlling blood pressure,hematodialysis(four cases),prostaglandin E1(five cases),hemoperfusion(one case),plasma exchange(one case),fresh frozen plasma(three cases),heparin(one case),aspirin(one case),dipyridamole(one case),adrenal cortical hormone(five cases) and immunodepressant(one case) and so on.Hematological system,liver and renal functions were all improved after therapy.There were significant differences between two groups in the changes of haemoglobin,platelet,serum creatinine,total bilirubin and lactate dehydrogenase(P＜0.05). On discharge two patients were missed diagnosed too long to be worse and gave up therapy, whereas,two patients were cured and four patients took a favorable turn.Conclusions:HUS is a rare and severe syndrome.Early diagnosis and correct therapy in time could improve the outcome.