By Bernard S. Kaplan M.B., B.Ch., F.C.P.(S.A.), Paul R. Goodyer M.D. (auth.), José Strauss MD (eds.)
My strategies concerning the Hemolytic Uremic Syndrome (HUS) obtained began in 1961 besides my try and go back to Argentina. As I sought my method in Buenos Aires, I visited Carlos Gianantonio whom I had met in Caracas the 12 months prior to throughout the Pan American pediatric conferences. at the moment he used to be actively engaged on HUS which had turn into a plague in Buenos Aires and different elements of Argentina. i used to be inspired by way of the workforce attempt and devotion of his crew to such heavy calls for. They evidently have been assembly the problem at an amazingly excessive point below a really crippling actual state of affairs with shortages of house, laboratories and gear. His workforce including Dr. Becu, on the time the pathologist on the kid's sanatorium of Buenos Aires (we had met via his mom who used to be instrumental in arranging my go back to Buenos Aires), wrote the various vintage papers on HUS. over the years as Dr. Gianantonio turned extra keen on common pediatrics, the executive features and its orientation in Latin the United States, he grew to become recognized for his deep philosophical questions as to what we're doing and the place we're going. His questions have seen implications concerning an agressive method of our pediatric nephrology patients.
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Additional resources for Acute Renal Disorders and Renal Emergencies: Proceedings of Pediatric Nephrology Seminar X held at Bal Harbour, Florida, January 30 – February 3, 1983
It is obvious that in Argentina the future efforts must be concentrated in prevention of the syndrome, once its epidemiology is unveiled. Table 8. Acute renal failure in infants and children (1975/1976). No. 9 658 100 Our present and most discouraging problem is the high incidence of kidney scarring with early uremia, and the late development of progressive glomerular damage, in a significant proportion of the patients. Our experience with infusions of fresh frozen plasma or plasma exchange is too limited and recent to be analyzed, especially in relation to its eventual influence on the late consequences of HUS.
Platelets 23 ACTIVATION OF PLATELETS As we shall show below, there is good evidence that platelets have been activated. The most logical triggering event for platelet activation in HUS is a microangiopathy in which there is damage to, and possibly detachment of, endothelial cells. Endothelial cell trauma may lead to release of their contents including factors which may influence platelet function; factor VIII levels are elevated in HUS (21-24). prostacyclin (PGI 2 ) ,is produced by endothelium and i t has an important anti-aggregating role.
40) Hyperreninernia comronlyoccurs in children Tre mechanism by which serum uric acid levels increase may be related to renin mediated changes in renal hemodynamics. It is not clear whether the elevated serum levels of uric acid in HUS are directly nephrotoxic. Acute uric acid nephropathy in children with lymphoproliferative disorders has occurred with serum uric acid levels similar to those observed in children with BUS. (41) damage by tW'o mechanisms. (18,19) Hyperuricemia may cause renal Firstly, uric acid may precipitate intraluminally, especially when urine fleM rates and pH are leM.
Acute Renal Disorders and Renal Emergencies: Proceedings of Pediatric Nephrology Seminar X held at Bal Harbour, Florida, January 30 – February 3, 1983 by Bernard S. Kaplan M.B., B.Ch., F.C.P.(S.A.), Paul R. Goodyer M.D. (auth.), José Strauss MD (eds.)