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Haemolytic-uraemic syndrome in childhood: surveillance and case-control studies in Italy

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Abstract

Seventy-six cases of haemolytic-uraemic syndrome (HUS) were collected over a 4-year period during a surveillance and case-control study. The annual incidence of 0.2 per 100,000 children aged 0–14 years is lower than in other countries; 34% had no prodromal diarrhoea. Evidence for verocytotoxin-producingEscherichia coli (VTEC) infection was found in 72% of patients and 3% of controls; 88% of patients with bloody diarrhoea, 67% with non-bloody diarrhoea and 55% without diarrhoea were VTEC positive. Seventy-three percent of patients had creatinine clearance ≥80 ml/min per 1.73 m2, normal blood pressure, no proteinuria and haematuria <2+ after 1 year of follow-up. One patient died and none had non-renal sequelae. VTEC positivity was significantly correlated with a good outcome, while the absence of diarrhoea and a high total white blood cell count at onset were not predictors of a bad outcome. Household contacts of HUS patients had diarrhoea more frequently than those of the control group, supporting the hypothesis of person-to-person transmission of VTEC infection.

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Author information

Correspondence to Alessandra Gianviti.

Additional information

Italian HUS Study Group: P. Pasquini, Epidemiology and Biostatistic Laboratory, Istituto Superiore di Sanità, Rome: A. Edefonti, A. Bettinelli-Paediatric Clinic of the University of Milan; A. Caringella, T. De Palo Division of Nephrology and Dialysis, Giovanni XXIII Children's Hospital, Bari; G. Capasso, N. De Santo, Chair of Nephrology of the 1st Faculty of Medicine of the University of Naples: S. Bassi, Division of Nephrology and Dialysis, Umberto Io Hospital, Brescia; G. Montini, G. Zacchello, Paediatric Department of the University of Padua; M. Gaido, R. Coppo, Division of Nephrology and Dialysis, Regina Margherita Children's Hospital, Turin; F. Perfumo, R. Gusmano, Division of Nephrology and Dialysis, G. Gaslini Children's Hospital, Genoa; E. Salvaggio, Paediatric Clinic of the A. Gemelli University of Rome; L. Peratoner, Paediatric Clinic of the University of Trieste; C. Setzu, Paediatric Division, G. Brotzu Hospital, Cagliari; A. Bosco, Division of Nephrology and Dialysis, G. Di Cristina Children's Hospital, Palermo; R. Penza, Paediatric Clinic of the University of Bari; M. Cecconi, Paediatric Clinic of the University of Ancona; I. Pela, Paediatric Clinic of the University of Florence

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Gianviti, A., Rosmini, F., Caprioli, A. et al. Haemolytic-uraemic syndrome in childhood: surveillance and case-control studies in Italy. Pediatr Nephrol 8, 705–709 (1994). https://doi.org/10.1007/BF00869095

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Key words

  • Haemolytic-uraemic syndrome
  • Surveillance study
  • Case-control study
  • Verocytotoxin-producingEscherichia coli infection