van Hoeve Karen, Vandermeulen Corinne, Van Ranst Marc, Levtchenko Elena, van den Heuvel Lambert, Mekahli Djalila
Department of Pediatric Nephrology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
University Vaccinology Center, KU Leuven - University of Leuven, 3000, Leuven, Belgium.
Eur J Pediatr. 2017 Apr;176(4):449-454. doi: 10.1007/s00431-017-2856-5. Epub 2017 Jan 21.
Hemolytic uremic syndrome (HUS) is a disease characterized by thrombotic microangiopathy with a triad of non-immune hemolytic anemia, thrombocytopenia, and renal impairment. Approximately 10% of cases of HUS are classified as atypical (aHUS). While today many genetically forms of aHUS pathology are known, only about 50% of carriers precipitate the disease. The reason remains unclear, and triggering events like intercurrent infections have been postulated. In rare cases, influenza A is the known trigger of aHUS; however, no cases of influenza B have been reported.
We describe for the first time that influenza B strain as a trigger for aHUS in children with primary hereditary forms. We also showed in our three cases that immunization appears to be safe; however, this needs to be confirmed in a larger cohort. What is Known: • Known triggers of aHUS are infectious specimen. • Influenza A-associated aHUS cases are rarely published. What is New: • aHUS can be triggered by influenza B virus infection. • Influenza vaccination of patients with aHUS appears safe.
溶血尿毒综合征（HUS）是一种以血栓性微血管病为特征的疾病，具有非免疫性溶血性贫血、血小板减少和肾功能损害三联征。大约10%的HUS病例被归类为非典型（aHUS）。虽然如今已知许多aHUS病理的遗传形式，但只有约50%的携带者会引发该疾病。原因尚不清楚，并发感染等触发事件已被提出。在罕见情况下，甲型流感是已知的aHUS触发因素；然而，尚无乙型流感引发aHUS的病例报告。
我们首次描述了乙型流感毒株作为原发性遗传形式儿童aHUS的触发因素。我们的三个病例还表明，免疫接种似乎是安全的；然而，这需要在更大的队列中得到证实。已知信息：• aHUS的已知触发因素是感染性样本。• 甲型流感相关的aHUS病例很少发表。新发现：• aHUS可由乙型流感病毒感染触发。• aHUS患者接种流感疫苗似乎是安全的。
