Karen van Hoeve1, Corinne Vandermeulen2, Marc Van Ranst3, Elena Levtchenko4,5, Lambert van den Heuvel5, Djalila Mekahli4,5. 1. Department of Pediatric Nephrology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. karenvanhoeve@yahoo.be. 2. University Vaccinology Center, KU Leuven - University of Leuven, 3000, Leuven, Belgium. 3. Department of Microbiology and Immunology, KU Leuven - Rega Institute, 3000, Leuven, Belgium. 4. Department of Pediatric Nephrology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. 5. Laboratory of Pediatrics, KU Leuven - University of Leuven, 3000, Leuven, Belgium.
Abstract
Hemolytic uremic syndrome (HUS) is a disease characterized by thrombotic microangiopathy with a triad of non-immune hemolytic anemia, thrombocytopenia, and renal impairment. Approximately 10% of cases of HUS are classified as atypical (aHUS). While today many genetically forms of aHUS pathology are known, only about 50% of carriers precipitate the disease. The reason remains unclear, and triggering events like intercurrent infections have been postulated. In rare cases, influenza A is the known trigger of aHUS; however, no cases of influenza B have been reported. CONCLUSION: We describe for the first time that influenza B strain as a trigger for aHUS in children with primary hereditary forms. We also showed in our three cases that immunization appears to be safe; however, this needs to be confirmed in a larger cohort. What is Known: • Known triggers of aHUS are infectious specimen. • Influenza A-associated aHUS cases are rarely published. What is New: • aHUS can be triggered by influenza B virus infection. • Influenza vaccination of patients with aHUS appears safe.
Hemolytic uremic syndrome (HUS) is a disease characterized by thrombotic microangiopathy with a triad of non-immune hemolytic anemia, thrombocytopenia, and renal impairment. Approximately 10% of cases of HUS are classified as atypical (aHUS). While today many genetically forms of aHUS pathology are known, only about 50% of carriers precipitate the disease. The reason remains unclear, and triggering events like intercurrent infections have been postulated. In rare cases, influenza A is the known trigger of aHUS; however, no cases of influenza B have been reported. CONCLUSION: We describe for the first time that influenza B strain as a trigger for aHUS in children with primary hereditary forms. We also showed in our three cases that immunization appears to be safe; however, this needs to be confirmed in a larger cohort. What is Known: • Known triggers of aHUS are infectious specimen. • Influenza A-associated aHUS cases are rarely published. What is New: • aHUS can be triggered by influenza B virus infection. • Influenza vaccination of patients with aHUS appears safe.
Authors: Lianne M Geerdink; Dineke Westra; Joanna A E van Wijk; Eiske M Dorresteijn; Marc R Lilien; Jean-Claude Davin; Martin Kömhoff; Koen Van Hoeck; Amerins van der Vlugt; Lambertus P van den Heuvel; Nicole C A J van de Kar Journal: Pediatr Nephrol Date: 2012-03-13 Impact factor: 3.714
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