Early Plasma Exchange Tied to Improved Course of HUS

Beneficial for adults with hemolytic uremic syndrome caused by E. coli O104:H4

FRIDAY, Aug. 26 (HealthDay News) -- Early plasma exchange therapy is associated with increased median platelet count and glomerular filtration rate, decreased median lactate dehydrogenase concentration, and improved neurological status in adults with diarrhea-associated hemolytic uremic syndrome (HUS), according to a study published online Aug. 25 in The Lancet.

Edin Colic, M.D., from Odense University Hospital in Denmark, and colleagues investigated the benefit of plasma exchange therapy in the management of diarrhea-associated HUS induced by shiga-toxin-producing Escherichia coli serotype O104:4. Five patients (median age 62 years) diagnosed with diarrhea-associated HUS were treated with daily plasma exchange by centrifugation and substitution with fresh, frozen plasma. Stool culture and serological testing were done to identify the cause of the disease, and changes in plasma count, glomerular filtration rate, and lactate dehydrogenase were evaluated to determine the success of disease management with plasma exchange therapy.

The investigators identified increased median platelet count and glomerular filtration rate, decreased lactate dehydrogenase concentration, and improved neurological status after plasma exchange. A significant inverse correlation was observed between the time intervals from onset of bloody diarrhea to start of plasma exchange with reduction of lactate dehydrogenase concentration by plasma exchange. Seven days (range five to eight) after starting plasma exchange, all the patients were discharged with normal neurological status.

"Early plasma exchange might ameliorate the course of diarrhea-associated hemolytic uremic syndrome in adults," the authors write.

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