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• W1989462850 abstract "Le syndrome hémolytique et urémique (SHU) est la première cause d’insuffisance rénale aiguë chez l’enfant de moins de 3 ans. Le SHU secondaire à Streptococcus pneumoniae (SP) est rare, mais sa fréquence augmente depuis 10 ans. Nous rapportons le cas d’une enfant, âgée de 3 ans et demi, atteinte d’un SHU atypique à SP de sérotype 3. Le diagnostic doit être évoqué par les multiples défaillances organiques du patient. Le risque de complications immédiates et à long terme impose une surveillance clinique et biologique avec possibilité de mettre en route une épuration extra-rénale sans délai. Afin de prévenir l’hémolyse induite, il est recommandé d’éviter la transfusion de plasma frais congelé et de produits sanguins non déplasmatisés. Cependant, dans les premières heures de sa prise en charge, notre patient avait reçu 2 poches de plasma frais congelé, sans qu’aucune complication n’apparaisse. Il est possible que l’augmentation de fréquence des SHU à SP soit en rapport avec la nouvelle écologie des sérotypes créée par la généralisation de la vaccination par Prévenar7®. Hemolytic uremic syndrome (HUS) is the primary cause of acute renal failure in children younger than 3 years of age. It usually occurs after a diarrheal illness due to Shiga-toxin-producing Escherichia coli. Streptococcus pneumoniae (SP)-induced HUS remains rare, involving 5% of all cases of HUS in children, but its frequency has increased over the last decade. The incidence of HUS following invasive pneumococcal infections is estimated at 0.4 to 0.6%. We report here the case of a 3.5-year-old child who presented SP serotype-3-associated HUS. The diagnosis was suspected by the patient's multiple organ failure. The pathogenesis involves the activation of the Thomsen-Friedenreich antigen. To prevent transfusion-associated hemolysis, it is recommended that fresh-frozen plasma or unwashed blood products should be avoided when possible. Our patient was transfused with 4 units of unwashed red blood cell and 2 units of fresh-frozen plasma. No special complication was noted. The risk of immediate complications requires close clinical and biological monitoring, and the possibility of starting dialysis immediately. Twenty-five to 35% of SP-HUS patients exhibit long-term renal aftereffects. The acute mortality rate depends on the site of infection. The increased frequency of SP-HUS may be related to the new ecology of serotypes created by widespread Prevenar7® vaccination." @default.
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• W1989462850 date "2012-06-01" @default.
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• W1989462850 title "Syndrome hémolytique et urémique secondaire à Streptococcus pneumoniae de sérotype 3" @default.
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• W1989462850 doi "https://doi.org/10.1016/j.arcped.2012.03.013" @default.
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