Thrombocytopenia is not mandatory to diagnose haemolytic and uremic syndrome

BMC Nephrology

Research Article

Khalil Ismail¹  Stéphane Burtey¹  Marion Sallée¹  Henri Vacher-Coponat¹  Julie Moussi-Francés¹  Fadi Fakhouri²  Véronique Frémaux-Bacchi³ 

[1] APHM, Hopital de la Conception, centre de néphrologie et transplantation rénale, Aix-Marseille Univ, 13005, Marseille, France;Département de Nephrologie, INSERM UMR643, CHU de Nantes, 1 place Alexis-Ricordeau, 44000, Nantes, France;Service d’immunologie biologique, hôpital Européen Georges-Pompidou, Assistance publique–Hôpitaux de Paris, 20-40, rue Leblanc, 75908, Paris cedex 15, France;

关键词: Hemolytic and uremic syndrome;    Thrombocytopenia;    Complement;   

DOI  :  10.1186/1471-2369-14-3

 received in 2012-07-18, accepted in 2013-01-02,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundHemolytic and uremic syndrome (HUS) diagnosis involves association of non immune hemolytic anemia, thrombocytopenia, and renal failure. HUS without thrombocytopenia has been observed, we call it partial HUS. Its real frequency and outcome are unknown. The aim of this study was to determine the prevalence of patients with normal platelets count in two HUS cohorts and to compare their outcome to patients with thrombocytopenia.MethodsWe retrospectively identified HUS diagnosis in two different cohorts. The first cohort was from a single center and consisted of all cases of HUS whatever the aetiology, the second was multicentric and consisted of atypical HUS patients. These cohorts were divided into two groups depending on the presence or absence of thrombocytopenia. Clinical and biological data were compared between thrombopenic and non thrombopenic group.ResultsWe identified 13% (20/150) of patients with normal platelets count: 10 episodes (18%) of HUS in six patients (14%) in the monocentric cohort and 14 patients (13%) with 17 episodes (12%) in the multicentric cohort of atypical HUS. Groups differed in platelets count and LDH level. In both cohorts, renal outcome was similar to patient presenting with thrombocytopenia.ConclusionHUS with normal platelets count is not infrequent. Relative to classical clinical presentation of HUS, partial HUS has similar characteristics and identical poor renal outcome and so must be treated in the same way.

【 授权许可】

Unknown   
© Sallée et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.