Plasma infusion as treatment for 33 children with haemolytic uraemic syndrome: a good therapy?

Between May 87 and December 91, 33 children aged from 2 months to 13 9/12 years were admitted for haemolytic uraemic syndrome (HUS). Treatment consisted of daily fresh-frozen plasma infusion (20 ml/kg/day) during 14 days. On admission, 20 patients (61%) had an oligoanuria: 18 underwent a peritoneal dialysis and 2 an haemodialysis with a median duration of dialysis of 14 days. A good outcome was rapidly observed in all patients. A normalisation of the platelet count and a sustained normal level of haemoglobin were obtained after a median of 8 days. The follow-up ranged from 7 months to 4 8/12 years: all patients had a normal blood pressure with correct growth. Only 3 children (9%) still had urinary abnormalities: one an isolated microscopic haematuria 3 years after diagnosis and 2 others a mild proteinuria after 1 3/12 year and 4 8/12 years with reduction of the renal function to 80% of the normal for the last one. In our series, plasma infusions lead to a rapidly favourable outcome in all patients and seem to be an effective therapy of HUS in childhood.