Neurodevelopmental long-term outcome in children after hemolytic uremic syndrome
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To investigate the long-term neurodevelopmental outcome in children after hemolytic uremic syndrome (HUS) and to compare outcome dependent on central nervous system (CNS) involvement during HUS.
A single-center retrospective cohort of 47 children was examined at a median age of 10.6 (range 6–16.9) years and a median follow-up of 7.8 (range 0.4–15.3) years after having had HUS. Intellectual performance was assessed with the German version of the Wechsler Intelligence Scale 4th version and neuromotor performance with the Zurich Neuromotor Assessment (ZNA). The occurrence of neurological symptoms during the acute phase of HUS was evaluated retrospectively.
Mean IQ of the whole study population fell within the normal range (median full scale IQ 104, range 54–127). Neuromotor performance was significantly poorer in the domains “adaptive fine,” “gross motor,” “static balance” (all p < 0.05) and “associated movements” (p < 0.001); only the “pure motor” domain was within the normal reference range. Neurological findings occurred in 16/47 patients (34 %) during acute HUS. Neurodevelopmental outcome was not significantly different between children with or without CNS involvement.
Our follow-up of children after HUS showed a favorable cognitive outcome. However, neuromotor outcome was impaired in all study participants. Neurological impairment during acute HUS was not predictive of outcome.
KeywordsIntellectual Motor Neurocognitive outcome Central nervous system involvement Hemolytic uremic syndrome
We thank all the children, adolescents and their parents who participated in this study. We also thank Luciano Molinari, PhD, and Burkhardt Seifert, PhD, for support with the statistical analysis and Christina Schaefer, MD, University Children’s Hospital Zurich, for performing the neurodevelopmental assessment. The honorarium of Kathrin Buder was supported by the Swiss Society of Nephrology and by the foundation “Kinder für Kinder”.
Conflict of interest
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