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Épidémiologie du syndrome hémolytique et urémique aigu postdiarrhéique de l'enfant dans quatre départements français
Authors:S Cloarec,G Deschê  nes,M Besson-Leaud,C Casenave,C Gambert,C Guyot,Y Hermouet,P Romanet,C Roy,S Benoit,H Nivet
Affiliation:1Unité de néphrologie pédiatrique, hôpital Gatien-de-Clocheville, 49, bd Béranger, 37044 Tours cedex, France;2service de pédiatrie, centre hospitalier de Saintes, 17108 Saintes cedex, France;3service de pédiatrie, centre hospitalier de Bourges, route de Nevers, 18000 Bourges, France;4service de pédiatrie, CHU de Poitiers, cité hospitalière de la Milétrie, hôpital Jean-Bernard, BP 577, 86000 Poitiers, France;5service de pédiatrie, CHU de Nantes, hôpital de la Mère et de l'Enfant, BP 1005, 44035 Nantes cedex 01, France;6service de pédiatrie, centre hospitalier de Rochefort, 16, rue du Docteur-Peltier, BP 9, 17301 Rochefort cedex, France;7département de médecine infantile, CHG de La Rochelle, 17019 La Rochelle cedex, France
Abstract:

Background.

Epidemiology of the hemolytic uremic syndrome (HUS) is best known in the English-speaking countries than in France.

Population and methods.

The attack rate of the HUS following acute gastro-enteritis in children was studied between 1982 and 1993 in four French departments (total population: 1,758,000). Investigations were performed with the cooperation of all the pediatric hospitals in each department. The pediatric population (0–4 years of age) remained stable at 4.8 to 5.3% during the study. Forty-nine children (22 girls, 27 boys) were included in this retrospective study.

Results.

All patients had hemolytic anemia with schizocytosis; thrombocytopenia was observed in 46/49 cases. Acute renal failure occurred in 48 cases. Twenty-five children required peritoneal dialysis (cumulative duration = 339 days). Four children (8.1 %) died. One patient is still in chronic renal failure after 3 years. Age at disease was less than 1 year in 18 cases, 1–2 years in 13, 2–3 years in nine, 3–4 years in six and 4–10 years in three. The attack rate for the 1982–1993 period for the patients less than 5 years of age was 51.7/100,000 (50.2–54). The mean of annual attack rate in the same group was 4.61/100,000 (range: 1.1–11.3), higher than the annual attack rate of acute HUS in Great Britain (3.1/100,000), Canada (3.1/100,000) and USA (2.7/100,000).

Conclusions.

The attack rate of HUS was similar inside each department even though country vs city dwellers and liverstock were unequally distributed.
Keywords:Author Keywords: syndrome hé  molytique et uré  mique   enté  rocolite   é  pidé  miologie
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