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Impact of platelet transfusions in children with post-diarrheal hemolytic uremic syndrome

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Abstract

Background

Platelet transfusions should be avoided in children with post-diarrheal hemolytic uremic syndrome (D + HUS) because they might increase microthrombi formation, thereby aggravating the disease. As this possibility has not yet been explored, we investigated whether platelet transfusion in patients with D + HUS would lead to a worse disease course compared to that in patients who did not receive platelet transfusion.

Methods

This was a case–control study in which data from D + HUS children who received platelet transfusions (cases, n  =  23) and those who did not (controls, n  =  54) were retrospectively reviewed and compared.

Results

Both patient groups were similar in age (p = 0.3), gender (p  =  0.53), weight (p  =  0.86), height (p  =  0.45), prior use of non-steroidal anti-inflammatory drugs (p  =  0.59) or antibiotics (p  =  0.45) and presence of dehydration at admission (p  =  0.79). The two groups also did not differ in initial leukocyte count (p  =  0.98), hematocrit (p  =  0.44) and sodium (p  =  0.11) and alanine aminotransferase levels (p  =  0.11). During hospitalization, dialysis duration (p  =  0.08), number of erythrocyte transfusions (p  =  0.2), serum creatinine peak (p  =  0.22), presence of severe bowel (p  =  0.43) or neurologic (p  =  0.97) injury, arterial hypertension (p  =  0.71), need for intensive care (p  =  0.33) and death (p  =  1.00) were also comparable.

Conclusion

Our findings suggest that platelet transfusion does not aggravate the course of the disease. Conversely, no hemorrhagic complications were observed in the group of patients who did not receive a platelet transfusion. Until these observations are confirmed by further studies, the benefits and risk of platelet transfusion should be thoughtfully balanced on an individual case basis.

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Acknowledgments

The authors wish to thank Dr. Mariana Anderson for her kind assistance in preparing this manuscript.

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Authors and Affiliations

  1. Nephrology Unit, Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina

    Alejandro Balestracci, Sandra Mariel Martin, Ismael Toledo, Caupolican Alvarado & Raquel Eva Wainsztein

  2. Unidad de Nefrología, Hospital General de Niños Pedro de Elizalde, Montes de Oca 40, CP 1270, Buenos Aires, Argentina

    Alejandro Balestracci

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  1. Alejandro Balestracci
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  2. Sandra Mariel Martin
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  3. Ismael Toledo
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  4. Caupolican Alvarado
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  5. Raquel Eva Wainsztein
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Correspondence to Alejandro Balestracci.

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Balestracci, A., Martin, S.M., Toledo, I. et al. Impact of platelet transfusions in children with post-diarrheal hemolytic uremic syndrome. Pediatr Nephrol 28, 919–925 (2013). https://doi.org/10.1007/s00467-013-2414-y

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  • DOI: https://doi.org/10.1007/s00467-013-2414-y

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