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Low levels of serum erythropoietin in children with endemic hemolytic uremic syndrome.
Exeni, R; Donato, H; Rendo, P; Antonuccio, M; Rapetti, M C; Grimoldi, I; Exeni, A; de Galvagni, A; Trepacka, E; Amore, A.
Afiliação
  • Exeni R; Nephrology Unit, Hospital del Niño, San Justo, Buenos Aires, Argentina.
Pediatr Nephrol ; 12(3): 226-30, 1998 Apr.
Article em En | MEDLINE | ID: mdl-9630043
Serum erythropoietin (EPO) levels were measured in ten previously non-transfused children with hemolytic uremic syndrome (HUS). Complete blood cell count, serum EPO, and renal function tests were carried out upon admission and weekly thereafter. Blood samples were obtained: (1) prior to the first transfusion; (2) after the first transfusion but before recovery from renal failure; (3) during the recovery stage. All patients required transfusions (mean 1.8+/-0.8 per child). Absolute values of EPO correlated positively with the hematocrit during the three stages (r = 0.53, 0.36, and 0.12, respectively) which is opposite to expected results. The observed EPO logarithm/predicted EPO logarithm upon admission was low (0.70+/-0.08), falling further during stage 2 (0.57+/-0.03), but increasing thereafter (0.78+/-0.07) without reaching normal values. The reticulocyte production rate followed a parallel course (0.74+/-0.14, 0.54+/-0.11, and 0.60+/-0.10, respectively). On comparing the observed serum EPO levels with those expected, 9 of 11 pre-transfusion samples showed low values; in stage 2, all samples were below normal; in the recovery phase most (77.8%) were still low. Our results show an inadequate EPO synthesis in children with HUS, which could play an important pathogenic role, since it aggravates the severity of the existing hemolytic anemia; the secondary inhibitory effect of repeated transfusions exacerbates this inadequate synthesis.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Eritropoetina / Síndrome Hemolítico-Urêmica Limite: Child, preschool / Humans / Infant Idioma: En Revista: Pediatr Nephrol Assunto da revista: NEFROLOGIA / PEDIATRIA Ano de publicação: 1998 Tipo de documento: Article País de afiliação: Argentina País de publicação: Alemanha
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Eritropoetina / Síndrome Hemolítico-Urêmica Limite: Child, preschool / Humans / Infant Idioma: En Revista: Pediatr Nephrol Assunto da revista: NEFROLOGIA / PEDIATRIA Ano de publicação: 1998 Tipo de documento: Article País de afiliação: Argentina País de publicação: Alemanha