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- Title
Direct cardiac involvement in childhood hemolytic-uremic syndrome: case report and review of the literature.
- Authors
Rigamonti, Davide; Simonetti, Giacomo; Simonetti, Giacomo D
- Abstract
Overhydration, hypertension, anemia, or dyselectrolytemias sometimes cause cardiovascular impairment in childhood hemolytic-uremic syndrome. Here, we report the case of a 4.5-year-old boy with hemolytic-uremic syndrome and sudden onset, 6 h later, of hemodynamic compromise secondary to a cardiac thrombotic micro-angiopathy. The child died. In the literature, we found 18 further cases with cardiac compromise ≤25 days after diagnosis. The following causes were found: micro-angiopathy, pericardial blood causing tamponade, and myocarditis.<bold>Conclusion: </bold>We were able to document only 19 cases of childhood hemolytic-uremic syndrome complicated by a direct cardiac compromise. Nonetheless, we speculate that a direct cardiac compromise accounts for many cases of childhood hemolytic-uremic syndrome complicated by sudden death during the initial hospitalization. Hence, we propose to always measure troponin in children with hemolytic-uremic syndrome to detect a latent myocardial damage. What is Known: • Overhydration, hypertension, anemia, or dyselectrolytemias sometimes cause cardiovascular impairment in childhood hemolytic-uremic syndrome. What is New: • This study documents 19 cases of childhood hemolytic-uremic syndrome complicated by a direct cardiac compromise ≤ 25 days after diagnosis. • The Following causes were found: micro-angiopathy, pericardial blood causing tamponade, and myocarditis.
- Subjects
SUDDEN death -- Risk factors; TROPONIN; THROMBOTIC thrombocytopenic purpura; MYOCARDIAL infarction; MYOCARDITIS; CHILDREN'S health; HEMOLYTIC-uremic syndrome diagnosis; ECHOCARDIOGRAPHY; HEART failure; HEMOLYTIC-uremic syndrome; TREATMENT effectiveness; ACUTE diseases; DISEASE complications
- Publication
European Journal of Pediatrics, 2016, Vol 175, Issue 12, p1927
- ISSN
0340-6199
- Publication type
journal article
- DOI
10.1007/s00431-016-2790-y