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Clinical Pediatrics
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Recurrent Hemolytic Uremic Syndrome

Richard L. Siegler, MD

University of Utah School of Medicine, Division of Nephrology and Hypertension, Department of Pediatrics, Salt Lake City, Utah

Andrew T. Pavia, MD

University of Utah School of Medicine, Division of Infectious Diseases, Department of Pediatrics, Salt Lake City, Utah

Joseph R. Sherbotie, MD

University of Utah School of Medicine, Division of Nephrology and Hypertension, Department of Pediatrics, Salt Lake City, Utah

Hemolytic uremic syndrome (HUS) in children follows a diarrheal prodrome (D+) approximately 90% of the time, and recurrence due to enteric reinfection with Shiga toxin producing E. coli (e.g., 0157:H7) can occur but is rare. It is not well recognized that nondiarrheal (D-) recurrences can also follow an episode of D+ HUS; we report 2 unrelated females who experienced multiple D-episodes following an initial episode of D+ HUS. We also present an HUS classification system that includes recurrence risk. It illustrates that recurrence is seen most frequently with familial HUS but can also occur in cases that are secondary to drugs, cancer, and pregnancy.

Clinical Pediatrics, Vol. 41, No. 9, 705-709 (2002)
DOI: 10.1177/000992280204100910
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