BACKGROUND: The aim of this study was to analyze the neurological involvement and outcome in pediatric patients with hemolytic uremic syndrome (HUS) during the 2011 epidemic caused by Escherichia coli O104:H4. METHODS: Clinical data and data from magnetic resonance imaging (MRI) scans and electroencephalography (EEG) during the acute phase of the disease and during follow-up at 3 and 6 months were analyzed in 50 patients. Twenty-five of these patients underwent neuropsychological testing (WISC IV) during follow-up. RESULTS: Neurological involvement (stupor or coma, seizures, visual disturbances, paresis, myocloni) was initially observed in 14/50 (28%) patients. One patient died. EEG abnormalities were more frequent in patients with neurological involvement than in those without (12/14 vs. 13/25, respectively). Cranial MRI scans were analyzed in nine patients with neurological involvement, of whom five showed abnormal findings. At the 3- and 6-month follow-ups, EEG abnormalities were found in 14/40 (35%) and 7/36 (19%) patients, respectively, whereas 28/42 (67%) and 17/39 (44%) patients, respectively, complained about on-going reduced performance. Neuropsychological testing showed a slightly lower global intelligence quotient in patients with neurological involvement versus those without (113.4 ± 2.8 vs. 119.4 ± 1.8, respectively). CONCLUSIONS: Neurological involvement was frequent in our cohort. Accordingly, the incidence of pathological EEG findings was high, even in patients without clinical signs of neurological involvement. Nevertheless, major neurological sequelae were rare, and neuropsychological outcome was favorable after 6 months.
BACKGROUND: The aim of this study was to analyze the neurological involvement and outcome in pediatric patients with hemolytic uremic syndrome (HUS) during the 2011 epidemic caused by Escherichia coli O104:H4. METHODS: Clinical data and data from magnetic resonance imaging (MRI) scans and electroencephalography (EEG) during the acute phase of the disease and during follow-up at 3 and 6 months were analyzed in 50 patients. Twenty-five of these patients underwent neuropsychological testing (WISC IV) during follow-up. RESULTS: Neurological involvement (stupor or coma, seizures, visual disturbances, paresis, myocloni) was initially observed in 14/50 (28%) patients. One patient died. EEG abnormalities were more frequent in patients with neurological involvement than in those without (12/14 vs. 13/25, respectively). Cranial MRI scans were analyzed in nine patients with neurological involvement, of whom five showed abnormal findings. At the 3- and 6-month follow-ups, EEG abnormalities were found in 14/40 (35%) and 7/36 (19%) patients, respectively, whereas 28/42 (67%) and 17/39 (44%) patients, respectively, complained about on-going reduced performance. Neuropsychological testing showed a slightly lower global intelligence quotient in patients with neurological involvement versus those without (113.4 ± 2.8 vs. 119.4 ± 1.8, respectively). CONCLUSIONS: Neurological involvement was frequent in our cohort. Accordingly, the incidence of pathological EEG findings was high, even in patients without clinical signs of neurological involvement. Nevertheless, major neurological sequelae were rare, and neuropsychological outcome was favorable after 6 months.
Authors: Frank Donnerstag; Xiaoqi Ding; Lars Pape; Eva Bültmann; Thomas Lücke; Jan Zajaczek; Ludwig Hoy; Anibh Martin Das; Heinrich Lanfermann; Jochen Ehrich; Hans Hartmann Journal: Eur Radiol Date: 2011-10-08 Impact factor: 5.315
Authors: Sebastian Loos; Thurid Ahlenstiel; Brigitta Kranz; Hagen Staude; Lars Pape; Christoph Härtel; Udo Vester; Laura Buchtala; Kerstin Benz; Bernd Hoppe; Ortraud Beringer; Martin Krause; Dominik Müller; Martin Pohl; Johanna Lemke; Georg Hillebrand; Martin Kreuzer; Jens König; Marianne Wigger; Martin Konrad; Dieter Haffner; Jun Oh; Markus J Kemper Journal: Clin Infect Dis Date: 2012-06-05 Impact factor: 9.079
Authors: Lars Pape; Hans Hartmann; Franz Christoph Bange; Sebastian Suerbaum; Eva Bueltmann; Thurid Ahlenstiel-Grunow Journal: Medicine (Baltimore) Date: 2015-06 Impact factor: 1.889
Authors: Ulrike Löbel; Nils Daniel Forkert; Peter Schmitt; Thorsten Dohrmann; Maria Schroeder; Tim Magnus; Stefan Kluge; Christina Weiler-Normann; Xiaoming Bi; Jens Fiehler; Jan Sedlacik Journal: PLoS One Date: 2016-11-01 Impact factor: 3.240