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.