Neuropsychological sequelae of haemolytic uraemic syndrome

Background-Severe haemolytic uraemic syndrome (HUS) in childhood can cause stroke, hemiplegia, cortical blindness, and psychomotor retardation. These outcomes are evident at the time of discharge immediately after the acute i llness. Less is known about the neuropsychological outcomes of less severel y affected children who recover from acute HUS. Aims-This multicentre case control study investigated the hypothesis that c hildren who survive an acute episode of HUS without recognisable neurologic al injuries have greater impairment of cognitive, academic, and behavioural functions than controls. Design-Children with HUS were eligible if they had no evidence of severe ne urological dysfunction when discharged from one of six Canadian hospitals. Controls had been admitted to hospital for a non-HUS illness and were match ed by age, sex, first language, and socioeconomic status. All subjects unde rwent evaluation of behaviour, academic achievement, cognitive function, an d verbal abilities using standardised tests administered by a psychometrist blinded to the case or control status. Results-Ninety one case control pairs were enrolled. No important differenc es between patients with HUS and paired controls were evident on tests of I Q, behaviour, verbal abilities, or academic achievement. There was no incre ased risk of attention deficit disorder among patients with HUS. There was no correlation between the severity of acute renal failure and neuropsychol ogical measures, although scores on some verbal ability tests were lower in those with the highest serum creatinine concentrations during illness. Conclusions-Children discharged from hospital without apparent neurological injury after an episode of acute HUS do not have an increased risk of subc linical problems with learning, behaviour, or attention.