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Neurodevelopmental long-term outcome in children after hemolytic uremic syndrome

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Abstract

Background

To investigate the long-term neurodevelopmental outcome in children after hemolytic uremic syndrome (HUS) and to compare outcome dependent on central nervous system (CNS) involvement during HUS.

Methods

A single-center retrospective cohort of 47 children was examined at a median age of 10.6 (range 6–16.9) years and a median follow-up of 7.8 (range 0.4–15.3) years after having had HUS. Intellectual performance was assessed with the German version of the Wechsler Intelligence Scale 4th version and neuromotor performance with the Zurich Neuromotor Assessment (ZNA). The occurrence of neurological symptoms during the acute phase of HUS was evaluated retrospectively.

Results

Mean IQ of the whole study population fell within the normal range (median full scale IQ 104, range 54–127). Neuromotor performance was significantly poorer in the domains “adaptive fine,” “gross motor,” “static balance” (all p < 0.05) and “associated movements” (p < 0.001); only the “pure motor” domain was within the normal reference range. Neurological findings occurred in 16/47 patients (34 %) during acute HUS. Neurodevelopmental outcome was not significantly different between children with or without CNS involvement.

Conclusions

Our follow-up of children after HUS showed a favorable cognitive outcome. However, neuromotor outcome was impaired in all study participants. Neurological impairment during acute HUS was not predictive of outcome.

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Acknowledgments

We thank all the children, adolescents and their parents who participated in this study. We also thank Luciano Molinari, PhD, and Burkhardt Seifert, PhD, for support with the statistical analysis and Christina Schaefer, MD, University Children’s Hospital Zurich, for performing the neurodevelopmental assessment. The honorarium of Kathrin Buder was supported by the Swiss Society of Nephrology and by the foundation “Kinder für Kinder”.

Conflict of interest

None.

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Authors and Affiliations

  1. Pediatric Nephrology Unit, University Children’s Hospital, Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland

    Kathrin Buder, Samuel Nef, Guido F. Laube & Giuseppina Spartà

  2. Child Development Center, University Children’s Hospital, Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland

    Beatrice Latal

  3. Children’s Hospital of Lucerne, Cantonal Hospital of Lucerne, 6000, Lucerne 16, Switzerland

    Thomas J. Neuhaus

Authors
  1. Kathrin Buder
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  2. Beatrice Latal
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  3. Samuel Nef
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  4. Thomas J. Neuhaus
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  6. Giuseppina Spartà
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Correspondence to Giuseppina Spartà.

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Buder, K., Latal, B., Nef, S. et al. Neurodevelopmental long-term outcome in children after hemolytic uremic syndrome. Pediatr Nephrol 30, 503–513 (2015). https://doi.org/10.1007/s00467-014-2950-0

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  • DOI: https://doi.org/10.1007/s00467-014-2950-0

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