Prediction of Prognosis in Patients with Hemolytic‐Uremic Syndrome

Hemolytic uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia and acute renal insufficiency. Recently we experienced 6 HUS patients who had different clinical modes of onset, different clinical courses and a poor prognosis compared with the patients with the above typical clinical pictures. Thirteen HUS patients were evaluated in two aspects: mode of onset (acute or gradual type) and clinical corn (non-recurrent or recurrent type). During 4.9 ± 3.1 (mean ± sd) years' of observation, renal insufficiency was more frequently observed in the gradual onset and recurrent course types respectively than in the acute onset and recurrent types (p < 0.05, p < 0.01). Also, the mean age was significantly lower and platelet counts were much higher in the gradual onset type than in the acute onset type (p < 0.05, p < 0.01). However, clinical findings except renal failure revealed no differences between non-recurrent and recurrent HUS. For the prediction of HUS, we emphasize the importance of classifying HUS by the mode of onset (acute or gradual) and/or clinical course (non-recurrent or recurrent).