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Hemolytic uremic syndrome more common in infants and young children. Cause is unknown, some children prior to the onset of fever or viral, it may be associated with infection or immune complex mediated by. If timely diagnosis and appropriate treatment to enable the part of the patient through the critical period to avoid death. Adult poor prognosis, and more left with chronic renal failure, need to maintain life-long dialysis or kidney transplantation.
Treatment principles: 1. Symptomatic treatment and supportive care; 2. To correct water-electrolyte and acid-base metabolism imbalance; 3. Blood purification therapy; 4. Anticoagulation therapy.
Medicine principles: 1. In general, first consider the application of medication to be confined "A"; 2. Poor efficacy, or patient serious condition, and then consider the use of medication to be confined "C".
Efficacy Evaluation: 1. Healing: hemolysis, bleeding stopped, reticulocyte 0.5-1.5%, urine examination was normal, with normal renal function; 2. Better: stop the bleeding, hemolysis greatly improved, normal urinalysis, renal function recovered; 3 . healed: bleeding, hemolysis is not controlled, renal function did not improve or become chronic renal failure.
Hemolytic uremic syndrome often with severe clinical critical, if it is found in patients with progressive anemia, acute renal failure, renal biopsy must be done against the clock to a regular hospital and blood purification timely rescue.
Posted at landlord reference 1st Floor The child dissolves the guts urine poisoning synthesizes toadvertise for the misdiagnosis reason analysis children with hemolytic uremic syndrome in children Misdiagnosis Abstract Objective: To learn more about children with hemolytic uremic The clinical manifestations of Syndrome .Abstract Objective: To deepen the hemolytic uremic syndrome in children with clinical manifestations of diversity awareness and improve diagnosis. Methods: 4 cases of hemolytic uremic syndrome in children from the epidemiological data, precursor performance, initial symptoms, progression of disease manifestations and laboratory results, clinicians and other aspects of the disease awareness of the causes of misdiagnosis. Results: The low incidence of the disease, clinical manifestation, laboratory tests show no characteristic of early, clinicians understand the disease and other factors are not enough clinicians to easily lead to misdiagnosis. Conclusion: Clinicians need to strengthen the understanding of the disease, broadening diagnostic thinking, presented several cases to consider this disease, timely diagnosis and improve prognosis in children.
Keywords Misdiagnosis of Hemolytic uremic syndrome
Hemolytic uremic syndrome (HUS) is a microvascular damage in children hemolytic anemia, acute renal failure (ARF) and thrombocytopenia as the main feature of the clinical syndrome, is caused by acute renal insufficiency in children one of the causes, prognosis than poor, great harm. Because the disease is not clinically common disease, clinicians often lack of knowledge of the disease, vigilance is not high, which led to the first consultation when the misdiagnosis, delayed treatment opportunity. Our hospital from January 2007 to December 2008 HUS patients were treated in 9 cases, 4 cases of misdiagnosis, misdiagnosis rate was 44.4% Reports are as follows.
1. Clinical data
1.1 General information on this group 4 cases, 3 males and 1 female, age 1 to 3 years in 3 cases, 3 years old, 1 case; 4 cases showed sporadic. Incidence of 2 cases for the autumn season, 1 for the spring, summer, 1 case; have denied the family history; denied history of animal bite; denied history of exposure to radiation.
1.2 4 cases of children with clinical manifestations of clinical manifestations of the precursor, non-specific to the gastrointestinal tract and respiratory tract symptoms, as shown in table Table 14 clinical cases of children precursorVomiting, abdominal pain 2
Diarrhea, loose stools 2 yellow-greenAfter these prodromal symptoms improved 2 to 3 days after, about a week later were again diarrhea, stool samples for the yellow-green or jam, there are varying degrees gradually pale, weakness, edema, decreased urine output, palpitation, drowsiness or irritability and other symptoms while hospitalized.
Check 1.3 Auxiliary important auxiliary examination after admission Table Peripheral white blood cell count and increased centriole 4Significantly higher blood urea nitrogen and creatinine 41.4 misdiagnosis misdiagnosis in this group 4 patients were misdiagnosed when first diagnosed, misdiagnosed as shown in table Table 34 cases of children misdiagnosis
The main clinical features of disease, the number of cases misdiagnosed
Fever, diarrhea, stool samples of acute amebic dysentery 1 jam
Yellow-green loose stools of diarrhea, vomiting, oliguria and mild dehydration enteritis in children 2
Pale, palpitation, cardiac auscultation News
And contraction of the former; CK-MB increased myocarditis 1
1.5 diagnosis, treatment and outcome of the situation3
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