The hemolytic-uremic syndrome: spectrum of severity and significance of prodrome
D. Dolislager and B. Tune
A review of our experience with the hemolytic-uremic syndrome (HUS)
illustrates a broad spectrum of severity. Comparison of this experience
with that in other parts of the world leads to the following conclusions:
(1) Nondiarrheal HUS may be sufficiently different from postdiarrheal HUS
to warrant separate consideration in clinical studies. (2) The Netherlands
more closely resembles California than Argentina in having patients with
less severe acute renal disease and a more favorable outcome. (3) In
California, with no specific therapy aimed at combating intravascular
coagulation, even oliguric or anuric postdiarrheal disease has a good
prognosis for survival (96%); the prognosis for recovery of normal renal
function is good in the large majority of patients oliguric or anuric for
two weeks or less (94%), but it is guarded in those with a longer period of
renal shutdown (57%). (4) Patients with nonoliguric disease have an
excellent prognosis for complete recovery. (5) Very mild and even
clinically inapparent cases exist and appear to be part of the spectrum of
the same process responsible for severe HUS.
