Gemolitiko-uremichesky syndrome
Contents:
Description:
Gemolitiko-uremichesky syndrome (vulture: Gasser's syndrome) is described by the Swiss pediatrician and the hematologist S. of Gasser in 1955.
It is observed mainly at children of the first year of life, proceeds extremely hard, the lethality makes 50 - 60%.
Reasons Gemolitiko-uremichesky syndrome:
The etiology of a disease is connected with acute intestinal infection. Most often - it is salmonellosis, dysentery if - an infection, and also entero-and arboviral, infections are more rare respiratory virus. There are data on a course of a disease after vaccination and reception of some drugs.
At this disease owing to immunopathological processes hemolysis, intravascular coagulation, a trombotichesky mikroangiopatiya, a trombotichesky glomerulitis, a cortical sclerosis develop. Also ischemic heart attacks of a brain and other bodies in which vessels fibrinous blood clots are formed are noted.
Salmonellosis - one of the reasons of a gemolitiko-uraemic syndrome
Symptoms Gemolitiko-uremichesky syndrome:
The triad is characteristic:
- hemolitic anemia;
- thrombocytopenia;
- acute renal failure.
During a disease allocate three periods: prodromal, heat, reparation:
- carry a disease of the child of the ostkry intestinal infection proceeding in the form of a gastroenterocolitis to a prodromal stage more rare there is a SARS; period duration sometimes of several days to 2 — 2,5 weeks;
- in the period of a heat pallor, sometimes with yellowness (hemolysis), hemorrhages in skin, the melena, a hamaturia, hematomas in places of injections, increase in duration of bleeding, decrease in retraction of a blood clot, (thrombocytopenia), an oliguria up to an anury appear, the relative density of urine at first is increased, then sharply decreases, a proteinuria; urine gains brown and rusty color because of availability in it of free hemoglobin.
Neurologic symptoms - spasms, a brain coma (the investigation of a hypocalcemia), arterial hypertension and hypostasis of a brain are possible.
The disease can proceed in extremely severe form, steadily progress and lead to death of the patient because of OPN, wet brain, heart failure, sepsis owing to a necrosis of thin and thick guts.
The diagnosis usually comes easy because of quite specific combination of symptoms. The hemolitic state is characterized by the fact that Koombs's reactions — direct and indirect - negative. The course of a disease after a gastroenterocolitis or (more rare) than a SARS is characteristic.
Treatment Gemolitiko-uremichesky syndrome:
It is directed first of all to stopping of OPN: perhaps early carrying out peritonealpy dialysis or extracorporal hemodialysis. Stopping of a syndrome of intravascular coagulation is carried out by administration of heparin, Streptokinasa. Control and correction of electrolytes and BRAIDS of blood is carried out.
