Síndrome urémico hemolítico en pediatría

Abstract

espanolEl Sindrome Uremico Hemolitico constituye una microangiopatia trombotica, es una de las principales causas de lesion renal aguda en ninos, ademas tiene un alto riesgo de morbimortalidad. Su etiologia es variable, con factores infecciosos y/o geneticos e incluso puede llegar a ser secundario a una patologia. Dentro de los hallazgos clinicos se presenta lesion renal aguda, trombocitopenia y anemia hemolitica microangiopatica, mas de la mitad de los pacientes presentan diarrea acuosa con disenteria, acompanada de otros sintomas gastrointestinales como dolor abdominal, nauseas y vomitos. Otras manifestaciones que se presentan en la minoria de pacientes son a nivel cardiaco, neurologico, oftalmologico y dermatologico. Para el diagnostico se requiere primero identificar clinicamente el Sindrome Uremico Hemolitico y posterior a esto es necesario indagar sobre la causa del mismo. Los examenes de laboratorio que se requieren para el diagnostico incluyen hemograma, pruebas de funcion renal, pruebas de funcion hepatica, examen general de orina y frotis de heces, ademas de examenes complementarios para identificar su causa. El tratamiento se debe instaurar lo antes posible con el fin de evitar o reducir las complicaciones agudas y las secuelas a largo plazo, siendo el tratamiento de soporte el manejo esencial. EnglishThe Hemolytic Uremic Syndrome constitutes a thrombotic microangiopathy, it is one of the main causes of acute kidney injury in children, it also has a high risk of morbimortality. Its etiology is variable, with infectious and / or genetic factors and may even be secondary to a pathology. The clinical findings include acute kidney injury, thrombocytopenia and microangiopathic hemolytic anemia, more than half of the patients have watery diarrhea with dysentery, accompanied by other gastrointestinal symptoms such as abdominal pain, nausea and vomiting. Other manifestations that occur in the minority of patients are cardiological, neurological, ophthalmological and dermatological. For the diagnosis, it is first necessary to identify the Hemolytic Uremic Syndrome clinically and after that it is necessary to investigate the cause of it. Laboratory tests that are required for diagnosis include a blood count, kidney function tests, liver function tests, a general urinalysis and stool smear, and complementary tests to identify the cause. Treatment should be established as soon as possible in order to avoid or reduce acute complications and long-term sequelae, with supportive treatment being the essential management.