Loos, Sebastian ORCID: 0000-0002-8620-042X, Aulbert, Wiebke, Hoppe, Bernd, Ahlenstiel-Grunow, Thurid, Kranz, Birgitta, Wahl, Charlotte, Staude, Hagen, Humberg, Alexander, Benz, Kerstin, Krause, Martin, Pohl, Martin, Liebau, Max C., Schild, Raphael, Lemke, Johanna, Beringer, Ortraud, Mueller, Dominik, Haertel, Christoph, Wigger, Marianne, Vester, Udo, Konrad, Martin, Haffner, Dieter, Pape, Lars, Oh, Jun and Kemper, Markus J. (2017). Intermediate Follow-up of Pediatric Patients With Hemolytic Uremic Syndrome During the 2011 Outbreak Caused by E. coli O104:H4. Clin. Infect. Dis., 64 (12). S. 1637 - 1644. CARY: OXFORD UNIV PRESS INC. ISSN 1537-6591

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Abstract

Background. In 2011 Escherichia coli O104:H4 caused an outbreak with >800 cases of hemolytic uremic syndrome (HUS) in Germany, including 90 children. Data on the intermediate outcome in children after HUS due to E. coli O104: H4 have been lacking. Methods. Follow-up data were gathered retrospectively from the medical records of patients who had been included in the German Pediatric HUS Registry during the 2011 outbreak. Results. Seventy-two of the 89 (81%) patients were included after a median follow-up of 3.0 (0.9-4.7) years. Hypertension and proteinuria were present in 19% and 28% of these patients, respectively. Of 4 patients with chronic kidney disease (CKD) > stage 2 at short-term follow-up, 1 had a normalized estimated glomerular filtration rate, and 3 (4%) had persistent CKD > stage 2. In 1 of these patients, CKD improved from stage 4 to 3; 1 who had CKD stage 5 at presentation received kidney transplantation; and 1 patient required further hemodialysis during follow-up. One patient (1.4%) still had major neurological symptoms at the latest follow-up. Dialysis during the acute phase (P =. 01), dialysis duration (P =. 01), and the duration of oligo-/anuria (P =. 005) were associated with the development of renal sequelae. Patients treated with eculizumab (n = 11) and/or plasmapheresis (n = 13) during the acute phase of HUS had comparable outcomes. Conclusions. The overall outcome of pediatric patients after HUS due to E. coli O104: H4 was equivalent to previous reports on HUS due to other types of Shiga toxin-producing E. coli (STEC). Regular follow-up visits in patients are recommended after STEC-HUS.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Loos, SebastianUNSPECIFIEDorcid.org/0000-0002-8620-042XUNSPECIFIED
Aulbert, WiebkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoppe, BerndUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ahlenstiel-Grunow, ThuridUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kranz, BirgittaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wahl, CharlotteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Staude, HagenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Humberg, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Benz, KerstinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krause, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pohl, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liebau, Max C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schild, RaphaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lemke, JohannaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Beringer, OrtraudUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller, DominikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haertel, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wigger, MarianneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vester, UdoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Konrad, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haffner, DieterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pape, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oh, JunUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kemper, Markus J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-227659
DOI: 10.1093/cid/cix218
Journal or Publication Title: Clin. Infect. Dis.
Volume: 64
Number: 12
Page Range: S. 1637 - 1644
Date: 2017
Publisher: OXFORD UNIV PRESS INC
Place of Publication: CARY
ISSN: 1537-6591
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ESCHERICHIA-COLI; CHILDREN; HUS; ECULIZUMAB; ADOLESCENT; SEQUELAE; NEEDMultiple languages
Immunology; Infectious Diseases; MicrobiologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/22765

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