Rasburicase in hemolytic uremic syndrome related to Shiga toxin-producing Escherichia coli: a report of nine cases.

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Alejandro BalestracciIsmael Toledo

Abstract

Hyperuricemia might induce additional renal damage in children with hemolytic uremic syndrome related to Shiga toxin-producing Escherichia coli (STEC-HUS). A few case reports have shown rasburicase to be effective in decreasing serum uric acid (UA) and improving renal function. However, there is only one report on the use of rasburicase in a child with STEC-HUS, which shows satisfactory results. We describe here the safety and efficacy of rasburicase in nine additional cases. Data from 9 children (5 females, median age 2 years) who received rasburicase were reviewed. At admission, 6 were dehydrated and 3 euvolemic. Dehydrated patients received saline solution and afterwards, as well as for those initially euvolemic, we aimed to keep a neutral fluid balance. Despite this, urine output did not increase. Baseline creatinine was 3.35 mg/dL (1.47-9.1) and UA 11.4 mg/dL (8.3-19.2). A single dose of rasburicase (0.2 mg/kg) was given 6-8 h after admission, which reduced UA levels to 1.8 mg/dL (0.3-5, p = 0.009) on the next day. However, renal parameters worsen and dialysis had to be initiated. Then, while still on dialysis, a UA rebound occurred in all cases reaching a peak of 8.9 mg/dL (4.5-13.8). Just after a steady increase in urine...Continue Reading

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Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·A Ahsan EjazRichard J Johnson
Nov 26, 2009·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·David J HobbsTimothy E Bunchman
Nov 18, 2011·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Alisa A Acosta, Ronald J Hogg
May 24, 2012·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Alejandro BalestracciIsmael Toledo
Aug 11, 2012·Clinical Journal of the American Society of Nephrology : CJASN·F Perry Wilson, Jeffrey S Berns
Jan 3, 2014·Indian Pediatrics·Rajiv Sinha, Priya Dugar
Dec 9, 2015·Pediatrics·Gianluigi ArdissinoErminio Torresani
Nov 2, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Myda Khalid, Sharon Andreoli
Apr 17, 2019·Nephron·Abutaleb Ahsan EjazBhagwan Dass

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Citations

Jul 29, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Ron Hogg
Jun 21, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Myung Hyun ChoHee Gyung Kang

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