The treatment of plasma exchange for the children with hemolytic uremic syndrome and follow-up

Du Yue; Wu Yu-bin; Han Mei

Abstract：Objectives To investigate the clinical characteristics of the children with hemolytic-uremic syndrome (HUS) and to verify the effect of plasma exchange in HUS. Methods We analyzed 9 patients with HUS in renal service in Shengjing Hospital of China Medical University from July 2001 to September 2007. All patients were analyzed with main symptoms, lab examinations, treatment efficiency of steroid and IVIG and plasma exchange (PE). All patients had been followed up from 0.5～6 years with treatment of oral administration of steroid. Results It seemed that there was no difference in the clinical characteristics and the lab examinations between the patients with D~+ HUS and D~- HUS. The pa-tients should be treated with plasma exchange as soon as possible if there was no effect with steroid or IVIG. Blood dialy-sis or plasma exchange would be added if there was no obvious effect with PE for the first time. Steroid would be orally administered by the HUS patients with proteinuria after PE, which was effective for proteinuria. Among the following 9 patients, 1 patient was followed with prgteinuria and was done with re-renal biopsy, which showed increased antigen and renal interstitial injury, 1 patient with hypertention. There was no abnormal signs for the other 7 patients. Conclu-sion It is effective for the patients with HUS treated with plasma exchange. It seems that oral administration of steroid is effective for the HUS patients with proteinuria. All patients with HUS should be paid more attention to in the long-term follow up.