溶血性尿毒症症候群における血漿交換療法

概要

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Hemolytic uremic syndrome (HUS) is one of the important causes of acute renal failure in both childhood and adults. Typical HUS in childhood, mainly caused by verotoxin-producing Escherichia coli, has a benign course and the mortality rate is less than 5%. In this form of HUS, neither plasma infusion therapy nor plasmapheresis has been demonstrated to have significant influence on the short- and medium-term clinical outcome, although renal pathological findings, Such as cortical necrosis, have been demonstrated to be less severe in the patients treated with plasma infusions in multicenter randomized trials. Therefore, plasmapheresis and plasmainfusion therapy has not generally been recommended for the first choice of therapy for typjcal childhood HUS. On the other hand, plasmapheresis and plasma-infusion therapy improved the prognosis of atypical childhood HUS and adult HUS/TTP (thrombotic thrombocytopenic purpura) syndrome and are recommended for the first choice of therapy for HUS/TTP syndrome.
1998-05-31