1. Cardiac involvement in pediatric hemolytic uremic syndrome.
- Author
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Tanné, Corentin, Javouhey, Etienne, Boyer, Olivia, Recher, Morgan, Allain-Launay, Emma, Monet-Didailler, Catherine, Rouset-Rouvière, Caroline, Ryckewaert, Amélie, Nobili, François, Gindre, Francine Arfbez, Rambaud, Jérôme, Duncan, Anita, Berthiller, Julien, Bacchetta, Justine, and Sellier-Leclerc, Anne-Laure
- Subjects
INTENSIVE care units ,SCIENTIFIC observation ,CARDIOMYOPATHIES ,TIME ,RETROSPECTIVE studies ,CASE-control method ,PEDIATRICS ,RISK assessment ,LEUKOCYTE count ,BLOOD platelet transfusion ,DESCRIPTIVE statistics ,HEMOLYTIC-uremic syndrome ,HOSPITAL care of children ,DISEASE risk factors ,DISEASE complications - Abstract
Background: Cardiac involvement is a known but rare complication of pediatric hemolytic uremic syndrome (HUS). We conducted a nationwide observational, retrospective case–control study describing factors associated with the occurrence of myocarditis among HUS patients. Methods: Cases were defined as hospitalized children affected by any form of HUS with co-existent myocarditis in 8 French Pediatric Intensive Care Units (PICU) between January 2007 and December 2018. Control subjects were children, consecutively admitted with any form of HUS without coexistent myocarditis, at a single PICU in Lyon, France, during the same time period. Results: A total of 20 cases of myocarditis were reported among 8 PICUs, with a mean age of 34.3 ± 31.9 months; 66 controls were identified. There were no differences between the two groups concerning the season and the typical, Shiga toxin-producing Escherichia coli (STEC-HUS), or atypical HUS (aHUS). Maximal leukocyte count was higher in the myocarditis group (29.1 ± 16.3G/L versus 21.0 ± 9.9G/L, p = 0.04). The median time between admission and first cardiac symptoms was of 3 days (range 0–19 days), and 4 patients displayed myocarditis at admission. The fatality rate in the myocarditis group was higher than in the control group (40.0% versus 1.5%, p < 0.001). Thirteen (65%) children from the myocarditis group received platelet transfusion compared to 19 (29%) in the control group (p = 0.03). Conclusion: Our study confirms that myocarditis is potentially lethal and identifies higher leukocyte count and platelet transfusion as possible risk factors of myocarditis. A higher resolution version of the Graphical abstract is available as Supplementary information [ABSTRACT FROM AUTHOR]
- Published
- 2022
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