Neuropsychological sequelae of haemolytic uraemic syndrome
The Canadian
Pediatric Kidney Disease Research Centre, 401 Smyth Rd, Ottawa,
Ontario, K1H 8L1, Canada
Correspondence to: Dr P C Rowe, Brady 212, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA. email: prowe{at}jhmi.edu
Accepted 8 September
1998
BACKGROUND
Severe
haemolytic uraemic syndrome (HUS) in childhood can cause stroke,
hemiplegia, cortical blindness, and psychomotor retardation. These
outcomes are evident at the time of discharge immediately after the
acute illness. Less is known about the neuropsychological outcomes of
less severely affected children who recover from acute HUS.
AIMSThis multicentre
case control study investigated the hypothesis that children who
survive an acute episode of HUS without recognisable neurological
injuries have greater impairment of cognitive, academic, and
behavioural functions than controls.
DESIGNChildren with
HUS were eligible if they had no evidence of severe neurological
dysfunction when discharged from one of six Canadian hospitals.
Controls had been admitted to hospital for a non-HUS illness and were
matched by age, sex, first language, and socioeconomic status. All
subjects underwent evaluation of behaviour, academic achievement,
cognitive function, and verbal abilities using standardised tests
administered by a psychometrist blinded to the case or control status.
RESULTSNinety
one case control pairs were enrolled. No important differences between
patients with HUS and paired controls were evident on tests of IQ,
behaviour, verbal abilities, or academic achievement. There was no
increased risk of attention deficit disorder among patients with HUS.
There was no correlation between the severity of acute renal failure
and neuropsychological measures, although scores on some verbal ability
tests were lower in those with the highest serum creatinine
concentrations during illness.
CONCLUSIONSChildren
discharged from hospital without apparent neurological injury after an
episode of acute HUS do not have an increased risk of subclinical
problems with learning, behaviour, or attention.
© 1999 by Archives of Disease in Childhood
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