Het hemolytisch-uremisch syndroom op de kinderleeftijd

- In Europe, haemolytic uraemic syndrome (HUS) is the most frequent cause of acute renal insufficiency during childhood.

- In the Netherlands about 20 children per year are seriously affected.

- Following a prodromal phase of mostly bloody diarrhoea, the main symptoms become evident, namely, haemolytic anaemia, thrombocytopenia and renal failure.

- The syndrome is caused by a verocytotoxin producing Escherichia coli, which damages the endothelium of the arterioles and glomeruli in the kidney. In humans, the most important cause of infection is the consumption of infected foodstuffs.

- After transport through the intestinal epithelium, the toxin becomes attached to the neutrophils, which transport it through the circulatory system, mainly to the kidneys where it has a toxic effect. Why the endothelial cells in these organs are the main targets for this toxin is as yet unknown.

- A symptomatic treatment is given to the 10 of infected patients who develop HUS. Increasing knowledge about the pathogenesis has resulted in new forms of treatment that will be studied during the next few years.