Shiga toxin-associated hemolytic uremic syndrome complicated by intestinal perforation in a child with typical hemolytic uremic syndrome
Korean Journal of Pediatrics 2014³â 57±Ç 2È£ p.96 ~ p.99
ÀåÈñÁø(Chang Hye-Jin) - Seoul National University College of Medicine Department of Pediatrics
±èÈ¿µ(Kim Hwa-Young) - Seoul National University College of Medicine Department of Pediatrics
ÃÖÀçÈ«(Choi Jae-Hong) - Seoul National University College of Medicine Department of Pediatrics
ÃÖÇöÁø(Choi Hyun-Jin) - Seoul National University College of Medicine Department of Pediatrics
°íÀ缺(Ko Jae-Sung) - Seoul National University School of Medicine Department of Pediatrics
ÇÏÀϼö(Ha Il-Soo) - Seoul National University College of Medicine Department of Pediatrics
Á¤ÇØÀÏ(Cheong Hae-Il) - Seoul National University College of Medicine Department of Pediatrics
(Choi Yong) - Seoul National University College of Medicine Department of Pediatrics
°Èñ°æ(Kang Hee-Gyung) - Seoul National University College of Medicine Department of Pediatrics
Abstract
Hemolytic uremic syndrome (HUS) is one of the most common causes of acute renal failure in childhood and is primarily diagnosed in up to 4.5% of children who undergo chronic renal replacement therapy. Escherichia coli serotype O157:H7 is the predominant bacterial strain identified in patients with HUS; more than 100 types of Shiga toxin-producing enterohemorrhagic E. coli (EHEC) subtypes have also been isolated. The typical HUS manifestations are microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency. In typical HUS cases, more serious EHEC manifestations include severe hemorrhagic colitis, bowel necrosis and perforation, rectal prolapse, peritonitis, and intussusceptions. Colonic perforation, which has an incidence of 1?2%, can be a fatal complication. In this study, we report a typical Shiga toxin-associated HUS case complicated by small intestinal perforation with refractory peritonitis that was possibly because of ischemic enteritis. Although the degree of renal damage is the main concern in HUS, extrarenal complications should also be considered in severe cases, as presented in our case.
Å°¿öµå
Intestinal perforation, Hemolytic uremic syndrome, Shiga toxin, Typical
KMID :
1130320140570020096
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸
À¯È¿¼º°á°ú(Recomendation)