Table 1.

Clinical characteristics, in-hospital course, and outcome of 113 children with post-diarrheal HUS, with comparison of Shiga toxin–positive and Shiga toxin–negative patients

Patient CharacteristicsStx-Positive HUS, n=79Stx-Negative HUS, n=34
Age, yr2.6 (1.4; 4.9)3.4 (1.6; 5.5)
Sex, men/women38/4117/17
Prodromal phase
Gastrointestinal manifestations
  Nonbloody diarrhea30 (38)14 (41)
  Bloody diarrhea40 (51)19 (56)
  Abdominal pain, vomiting, without diarrhea9 (11)1 (3)
Fever ≥38°C27 (34)15 (44)
 Upper respiratory tract infection/otitis5 (6)2 (6)
 Antibiotics14 (18)12 (35)
In-hospital
At admission
  Hemoglobin, g/dl7.7 (6.3; 9.5)7.6 (6.1; 9.3)
  Hemoglobin >9 g/dl25/77 (33)9 (26)
  LDH, U/L3010 (2193; 4744)2619 (1151; 4056)
  Platelet count, G/L40 (27; 56)48 (37; 77)
  Leukocyte count, /mm313,070 (10,200; 20,030)12,400 (9535; 18,200)
  Leukocyte count >20,000/mm318/69 (26)6/31 (19)
 STEC investigations
  Stool PCR for Stx
   Stx1 positive1 (1)0
   Stx2 positive69 (87)0
   Stx1+Stx2 positive9 (11)0
  Stool culture
   E. coli O15737/77 (48)1a (3)
   E. coli other than O15725/77 (32)1a (3)
   Nontypable E. coli10/77 (13)2a (6)
  Anti-LPS serology33/64 (52)17/29 (59)
   Positive
Clinical course
  Anuria33 (42)12 (35)
  Central nervous system manifestations18 (23)2 (6)
  Prolonged intestinal manifestations22 (28)6 (18)
  Pancreatitis11 (14)4 (12)
  Cardiac manifestations2 (3)0
  Death00
Treatment
  Dialysis44 (56)14 (41)
  Dialysis duration, d9 (4; 16)9 (7; 16)
  Dialysis duration >8 d25/44 (57)10/14 (71)
  Plasma infusion and/or plasma exchange8 (10)1 (3)
  Eculizumab12 (15)3 (9)
  Antibiotics27 (34)9 (26)
At last follow-up
 Follow-up, mo46 (18; 65)53 (33; 61)
 No CKDb52/73 (71)27/31 (87)
 CKD stage 1b16/73 (22)2/31 (6)
 CKD stage 2b1/73 (1)2/31 (6)
 CKD stage 3b3/73 (4)0
 CKD stage 4b00
 CKD stage 5b1/73 (1)0
  • Values are shown as number (%) of patients or median (Q1; Q3). For items not documented in all patients, the number of documented patients is indicated and served for the calculation of the percentage indicated in brackets. No CKD was defined by eGFR≥90 ml/min per 1.73 m2 without albuminuria; CKD stage 1 by eGFR≥90 ml/min per 1.73 m2 with albuminuria; CKD stage 2 by eGFR 60–89 ml/min per 1.73 m2 with albuminuria. See Supplemental Material for the definition of CKD stages 3–5 and albuminuria. HUS, hemolytic uremic syndrome; Stx, Shiga toxin; LDH, lactate dehydrogenase; STEC, Shiga toxin producing E. coli; LPS, lipopolysaccharide.

  • a Non-Stx producing E. coli strains.

  • b CKD stages according to Kidney Disease Improving Global Outcomes Guidelines 2012 (http://www.kdigo.org/clinical_practice_guidelines/pdf/CKD/KDIGO_2012_CKD_GL.pdf).