GASTROINTESTINAL MANIFESTATIONS OF HEMOLY TIC-UREMIC SYNDROME IN CHILDREN

Background. - Gastro-intestinal manifestations are relatively frequent during the course of hemolytic uremic syndrome (HUS), some of them re quiring special supportive care. This work was aimed at retrospectivel y studying gastrointestinal manifestations of HUS and determining thei r place in the prognosis. Patients. - Thirty-seven children aged 4 mon ths to 11 years (22 girls and 15 boys) were included in the study. Res ults. - All children but one had gastrointestinal prodromes. During th e course of HUS, various manifestations were seen : bloody diarrhea in 32% of patients, ileo-ileal intussusception in 3%, rectal prolapse in 8% and hepatic cytolysis in 38%. Seven patients with bloody diarrhea had a complicated course, lethal in one. Comparison between these seve n children and the 30 others revealed some indicators of severe gut in volvement : female seg short duration of gastrointestinal prodromes, h emorrhagic colitis with rectal prolapse, high WBC count, high neutroph ils count and less important degree of anemia at admission. Severity o f the gastrointestinal lesions was correlated with that of the outcome of the renal disease. Conclusion. - Gastrointestinal tract is frequen tly affected in HUS and severe complications can appear, potentially l eading to death. Total parenteral nutrition could prevent occurrence o f gastrointestinal complications. Severe gastrointestinal lesions are associated with a poor renal outcome.