Threatening Blindness in a Child With Typical Hemolytic Uremic Syndrome.

Blindness Children Hemolytic uremic syndrome Retinopathy Thrombotic microangiopathy

Journal

Pediatric neurology
ISSN: 1873-5150
Titre abrégé: Pediatr Neurol
Pays: United States
ID NLM: 8508183

Informations de publication

Date de publication:
09 2021
Historique:
received: 20 03 2021
revised: 06 05 2021
accepted: 14 06 2021
pubmed: 23 7 2021
medline: 24 2 2022
entrez: 22 7 2021
Statut: ppublish

Résumé

Hemolytic uremic syndrome (HUS) is the most common cause of acute kidney failure in children younger than five years. Central nervous system involvement occurs in 15% of patients, with clinical manifestations including confusion, coma, seizures, stroke, and cortical blindness. Ocular involvement in children with HUS is rare, but retinal and choroidal hemorrhages as well as ischemic retinopathy due to thrombotic microangiopathic lesions have been documented. We describe a 26-month-old girl with typical HUS who experienced severe visual loss likely resulting from cytotoxic injury of both lateral geniculate nuclei with bilateral damage to optic pathways coupled with macular thrombotic microangiopathic lesions. Her vision recovered completely within a month in conjunction with the normalization of her imaging studies. Although this child's vision was severely impaired, the prognosis for this mixed visual impairment of peripheral and central origin was excellent with a full recovery.

Sections du résumé

BACKGROUND
Hemolytic uremic syndrome (HUS) is the most common cause of acute kidney failure in children younger than five years. Central nervous system involvement occurs in 15% of patients, with clinical manifestations including confusion, coma, seizures, stroke, and cortical blindness. Ocular involvement in children with HUS is rare, but retinal and choroidal hemorrhages as well as ischemic retinopathy due to thrombotic microangiopathic lesions have been documented.
PATIENT DESCRIPTION
We describe a 26-month-old girl with typical HUS who experienced severe visual loss likely resulting from cytotoxic injury of both lateral geniculate nuclei with bilateral damage to optic pathways coupled with macular thrombotic microangiopathic lesions. Her vision recovered completely within a month in conjunction with the normalization of her imaging studies.
CONCLUSIONS
Although this child's vision was severely impaired, the prognosis for this mixed visual impairment of peripheral and central origin was excellent with a full recovery.

Identifiants

pubmed: 34293637
pii: S0887-8994(21)00130-2
doi: 10.1016/j.pediatrneurol.2021.06.008
pii:
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

35-37

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Anaïs Corgier-Pattberg (A)

Department of Multidisciplinary Pediatrics, APHM La Timone, Marseille, France.

Marie Beylerian (M)

Department of Paediatric Ophtalmology, APHM Hôpital Nord, Marseille, France.

Stephanie Clave (S)

Department of Multidisciplinary Pediatrics, APHM La Timone, Marseille, France.

Mathilde Cailliez (M)

Department of Multidisciplinary Pediatrics, APHM La Timone, Marseille, France.

Benoit Testud (B)

CEMEREM, APHM La Timone, Marseille, France; Aix-Marseille University, CNRS, CRMBM, UMR 7339, Marseille, France; Department of Neuroradiology, APHM La Timone, Marseille, France.

Beatrice Desnous (B)

Department of Paediatric Neurology, APHM La Timone, Marseille, France. Electronic address: beadesnous@gmail.com.

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Classifications MeSH