Cholelithiasis following Escherichia coli O157:H7-associated hemolytic uremic syndrome. Pediatr Nephrol 1998 Apr;12(3):222-5
Date
06/18/1998Pubmed ID
9630042DOI
10.1007/s004670050442Scopus ID
2-s2.0-0031946665 (requires institutional sign-in at Scopus site) 36 CitationsAbstract
Sequelae of Escherichia coli O157:H7-associated hemolytic uremic syndrome (HUS) 2-3 years following an outbreak in Washington State have been prospectively studied to identify predictors of adverse sequelae. Logistic regression analysis was used to examine associations between findings in the acute course and long-term renal and gastrointestinal outcomes. Twenty-one percent of patients had gastrointestinal sequelae, which included cholelithiasis resulting in cholecystectomy (3/29), persistent pancreatitis (2/29), late colon stricture (1/29), and/or glucose intolerance (1/29). Logistic regression analysis found long-term gastrointestinal sequelae were higher in patients who, during HUS, had hypertension [odds ratio (OR) = 21.2, 95% confidence interval (CI) = 1.9-164.4, P = 0.01] or gastrointestinal complications (OR = 21.2, 95% CI = 1.9-164.4, P = 0.01). Renal sequelae were seen in 35% of patients. One patient (4%) had persistent hypertension and 9 (31%) had minor urinary findings (hematuria or proteinuria). Thrombocytopenia lasting longer than 10 days during the acute illness was associated with a risk for subsequent renal sequelae (OR = 15.0, 95% CI = 1.98-1,703.0, P = 0.009). We conclude a high incidence of gastrointestinal sequelae, especially cholelithiasis presenting long after the acute illness, may be seen with HUS. The short follow-up period may underestimate the extent and severity of eventual renal sequelae.
Author List
Brandt JR, Joseph MW, Fouser LS, Tarr PI, Zelikovic I, McDonald RA, Avner ED, McAfee NG, Watkins SLAuthor
Ellis D. Avner MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
ChildChild, Preschool
Cholelithiasis
Escherichia coli Infections
Female
Follow-Up Studies
Hemolytic-Uremic Syndrome
Humans
Infant
Male