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==Overview==
==Overview==
The highest proportion of [[Hemolytic-uremic syndrome|hemolytic uremic syndrome]] [[Hemolytic-uremic syndrome|(HUS)]] cases (15.3%) occurred among children aged <5 years. [[Hemolytic-uremic syndrome|HUS]] affects female more than male and white race more than other races. [[Mortality]] is more commonly seen in [[elderly]] [[Patient|patients]] in which [[disease]] is less common but more dangerous.The incidence of atypical [[Hemolytic-uremic syndrome|HUS]] in The United States of America is approximately two per million.


==Epidemiology and Demographics==
==Epidemiology and Demographics==
===Incidence===
===Incidence===
*The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.<ref name="pmid27723152">{{cite journal |vauthors=Karpman D, Loos S, Tati R, Arvidsson I |title=Haemolytic uraemic syndrome |journal=J. Intern. Med. |volume=281 |issue=2 |pages=123–148 |date=February 2017 |pmid=27723152 |doi=10.1111/joim.12546 |url=}}</ref>
*In children less than 5 years of age, the incidence of [[Hemolytic-uremic syndrome|hemolytic uremic syndrome]] [[HUS|(HUS)]] is approximately 8.5 per 100,000.<ref name="MeleRemuzzi2014">{{cite journal|last1=Mele|first1=Caterina|last2=Remuzzi|first2=Giuseppe|last3=Noris|first3=Marina|title=Hemolytic uremic syndrome|journal=Seminars in Immunopathology|volume=36|issue=4|year=2014|pages=399–420|issn=1863-2297|doi=10.1007/s00281-014-0416-x}}</ref>
*In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
*The incidence of atypical [[Hemolytic-uremic syndrome|HUS]] in the United States of America is approximately 0.2 per 100,00 individuals.<ref name="pmid15168377">{{cite journal| author=Constantinescu AR, Bitzan M, Weiss LS, Christen E, Kaplan BS, Cnaan A et al.| title=Non-enteropathic hemolytic uremic syndrome: causes and short-term course. | journal=Am J Kidney Dis | year= 2004 | volume= 43 | issue= 6 | pages= 976-82 | pmid=15168377 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15168377  }}</ref>
 
is difficult to assess the annual incidence of EHEC‐associated HUS, but overall rates corresponding to two per 100 000 for all age groups have been reported and up to six per 100 000 in children younger than 5 years of age 51.
 
he incidence in Argentina has been reported to be as high as 12.2 cases per 100 000 children younger than 5 years of age 50. It is difficult to assess the annual incidence of EHEC‐associated HUS, but overall rates corresponding to two per 100 000 for all age groups have been reported and up to six per 100 000 in children younger than 5 years of age 51.
 


The incidence of hemolytic uremic syndrome (HUS)  is approximately 2 per 100,000 individuals worldwide for all age groups.
===Mortality rate===
The prevalence of hemolytic uremic syndrome (HUS) is approximately 6 per 100,000 in children younger than 5 years old.
* [[Mortality]] is more commonly seen in [[elderly]] [[Patient|patients]] in which [[disease]] is less common but more dangerous.<ref name="pmid19827953">{{cite journal| author=Gould LH, Demma L, Jones TF, Hurd S, Vugia DJ, Smith K et al.| title=Hemolytic uremic syndrome and death in persons with Escherichia coli O157:H7 infection, foodborne diseases active surveillance network sites, 2000-2006. | journal=Clin Infect Dis | year= 2009 | volume= 49 | issue= 10 | pages= 1480-5 | pmid=19827953 | doi=10.1086/644621 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19827953  }} </ref>


===Prevalence===
*In 2017, the [[Mortality rate|mortality]] of [[Hemolytic-uremic syndrome|hemolytic uremic syndrome]] (HUS) is estimated to approximately 10%.<ref>{{Cite journal
*The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
| author = [[Gregory Hall]], [[Shinichiro Kurosawa]] & [[Deborah J. Stearns-Kurosawa]]
*In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
| title = Shiga Toxin Therapeutics: Beyond Neutralization
*The prevalence of [disease/malignancy] is estimated to be [number] cases annually.
| journal = [[Toxins]]
 
| volume = 9
===Case-fatality rate/Mortality rate===
| issue = 9
*In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate/mortality rate of [number range]%.
| year = 2017
*The case-fatality rate/mortality rate of [disease name] is approximately [number range].
| month = September
| doi = 10.3390/toxins9090291
| pmid = 28925976
}}</ref>


===Age===
===Age===
*Patients of all age groups may develop hemolytic uremic syndrome (HUS).
*Patients of all age groups may develop [[Hemolytic-uremic syndrome|hemolytic uremic syndrome]] ([[Hemolytic-uremic syndrome|HUS]]).
*The incidence of HUS increases with age; the median age at diagnosis is younger than 5 years.
*The incidence of [[Hemolytic-uremic syndrome|HUS]] increases with age; the median age at [[diagnosis]] is younger than 5 years.<ref name="KarpmanLoos2017">{{cite journal|last1=Karpman|first1=Diana|last2=Loos|first2=Sebastian|last3=Tati|first3=Ramesh|last4=Arvidsson|first4=Ida|title=Haemolytic uraemic syndrome|journal=Journal of Internal Medicine|volume=281|issue=2|year=2017|pages=123–148|issn=09546820|doi=10.1111/joim.12546}}</ref>
*HUS commonly affects individuals younger 5 older than [number of years] years of age.
*[Chronic isease name] is usually first diagnosed among [age group].
*[Acute disease name] commonly affects [age group].
 
 
EHEC‐associated HUS occurs primarily in children younger than 5 years of age and in the elderly 34, 35. After an incubation period of 4–7 days, EHEC‐infected patients develop diarrhoea 36 and approximately 15% of cases develop HUS 11 within an additional 2–10 days. Patients may be infected by intake of contaminated food including raw, processed or undercooked meat, vegetables, unpasteurized juice or milk products, cross‐contamination of food products and utensils, intake of contaminated water, even from swimming pools 5, 37-42, person‐to‐person transmission 43, 44 or contact with animals bearing the strain 45. Transmission occurs more often in summer 46, requires a very low number of bacterial organisms 47 and occurs in outbreaks or sporadically. Very large outbreaks have occurred in Japan 48 and in Germany 16, but smaller outbreaks have been reported in numerous countries 5-10. In countries in which intake of raw meat is higher, EHEC infection is endemic and HUS rates are thus higher, such as in Argentina 49. The incidence in Argentina has been reported to be as high as 12.2 cases per 100 000 children younger than 5 years of age 50. It is difficult to assess the annual incidence of EHEC‐associated HUS, but overall rates corresponding to two per 100 000 for all age groups have been reported and up to six per 100 000 in children younger than 5 years of age 51.
 
Many strains of E. coli have been associated with clinical disease including sorbitol non‐fermenting and fermenting E. coli O157 as well as E. coli O26, O103, O111 and O145. E. coli O104:H4 was the specific strain isolated during the large German outbreak in 2011. This is a hybrid strain bearing characteristics of both EHEC strains (producing Shiga toxin) and enteroaggregative E. coli (EAEC) strains (with regard to the pattern of intestinal colonization) 52.
 
aHUS is an ultra‐rare disease with an estimated incidence that is most probably between 0.5 and 2 per million 53, 54. Onset may occur at any age but is more frequent in childhood 55 particularly before the age of 2 years 56. Onset before 6 months of age is highly indicative of aHUS as EHEC‐associated HUS is uncommon in this age group. The onset is usually triggered by a febrile infection in the respiratory or gastrointestinal tract. Patients who do not develop end‐stage renal failure during the first episode tend to relapse, and the disease may affect several members of the same family 57.


*[[Hemolytic-uremic syndrome|HUS]] commonly affects individuals younger than 5 years of age.<ref name="KarpmanLoos2017">{{cite journal|last1=Karpman|first1=Diana|last2=Loos|first2=Sebastian|last3=Tati|first3=Ramesh|last4=Arvidsson|first4=Ida|title=Haemolytic uraemic syndrome|journal=Journal of Internal Medicine|volume=281|issue=2|year=2017|pages=123–148|issn=09546820|doi=10.1111/joim.12546}}</ref>
===Race===
===Race===
*There is no racial predilection to [disease name].
*[[Hemolytic-uremic syndrome|HUS]] usually affects individuals of the White race (82%).<ref name=":0" /> 
*[Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].
===Gender===
===Gender===
*[Disease name] affects men and women equally.
*[[HUS]] affects female more than male. Approximately 59% of affected individuals are female.<ref name=":0">{{Cite journal
*[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
| author = [[Deirdra R. Terrell]], [[Sara K. Vesely]], [[Johanna A. Kremer Hovinga]], [[Bernhard Lammle]] & [[James N. George]]
 
| title = Different disparities of gender and race among the thrombotic thrombocytopenic purpura and hemolytic-uremic syndromes
===Region===
| journal = [[American journal of hematology]]
*The majority of [disease name] cases are reported in [geographical region].
| volume = 85
 
| issue = 11
*[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
| pages = 844–847
 
| year = 2010
===Developed Countries===
| month = November
| doi = 10.1002/ajh.21833
| pmid = 20799358
}}</ref>


===Developing Countries===
=== '''Region''' ===
* In the United States and Western Europe, the reported annual [[Incidence (epidemiology)|incidence]] of [[Escherichia coli enteritis|STEC]] ([[Shiga toxin-producing E. coli|Shiga Toxin-Producing E.coli]]) [[Hemolytic-uremic syndrome|HUS]] is approximately two to three per 100,000 children less than five years of age.<ref name="pmid15728781">{{cite journal| author=Noris M, Remuzzi G| title=Hemolytic uremic syndrome. | journal=J Am Soc Nephrol | year= 2005 | volume= 16 | issue= 4 | pages= 1035-50 | pmid=15728781 | doi=10.1681/ASN.2004100861 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15728781  }} </ref>
* Data on [[Pediatrics|paediatric]] [[Hemolytic-uremic syndrome|HUS]] established for some European countries (France, Germany, Austria and Italy) show an estimated prevalence of atypical HUS of 7 per million children in the whole of the European Community.<ref name="pmid19821824">{{cite journal| author=Taylor CM, Machin S, Wigmore SJ, Goodship TH, working party from the Renal Association, the British Committee for Standards in Haematology and the British Transplantation Society| title=Clinical practice guidelines for the management of atypical haemolytic uraemic syndrome in the United Kingdom. | journal=Br J Haematol | year= 2010 | volume= 148 | issue= 1 | pages= 37-47 | pmid=19821824 | doi=10.1111/j.1365-2141.2009.07916.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19821824  }} </ref>


==References==
==References==

Latest revision as of 15:15, 22 August 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sogand Goudarzi, MD [2], Anila Hussain, MD [3]

Overview

The highest proportion of hemolytic uremic syndrome (HUS) cases (15.3%) occurred among children aged <5 years. HUS affects female more than male and white race more than other races. Mortality is more commonly seen in elderly patients in which disease is less common but more dangerous.The incidence of atypical HUS in The United States of America is approximately two per million.

Epidemiology and Demographics

Incidence

  • In children less than 5 years of age, the incidence of hemolytic uremic syndrome (HUS) is approximately 8.5 per 100,000.[1]
  • The incidence of atypical HUS in the United States of America is approximately 0.2 per 100,00 individuals.[2]

Mortality rate

Age

  • HUS commonly affects individuals younger than 5 years of age.[5]

Race

  • HUS usually affects individuals of the White race (82%).[6]

Gender

  • HUS affects female more than male. Approximately 59% of affected individuals are female.[6]

Region

  • In the United States and Western Europe, the reported annual incidence of STEC (Shiga Toxin-Producing E.coli) HUS is approximately two to three per 100,000 children less than five years of age.[7]
  • Data on paediatric HUS established for some European countries (France, Germany, Austria and Italy) show an estimated prevalence of atypical HUS of 7 per million children in the whole of the European Community.[8]

References

  1. ↑ Mele, Caterina; Remuzzi, Giuseppe; Noris, Marina (2014). "Hemolytic uremic syndrome". Seminars in Immunopathology. 36 (4): 399–420. doi:10.1007/s00281-014-0416-x. ISSN 1863-2297.
  2. ↑ Constantinescu AR, Bitzan M, Weiss LS, Christen E, Kaplan BS, Cnaan A; et al. (2004). "Non-enteropathic hemolytic uremic syndrome: causes and short-term course". Am J Kidney Dis. 43 (6): 976–82. PMID 15168377.
  3. ↑ Gould LH, Demma L, Jones TF, Hurd S, Vugia DJ, Smith K; et al. (2009). "Hemolytic uremic syndrome and death in persons with Escherichia coli O157:H7 infection, foodborne diseases active surveillance network sites, 2000-2006". Clin Infect Dis. 49 (10): 1480–5. doi:10.1086/644621. PMID 19827953.
  4. ↑ Gregory Hall, Shinichiro Kurosawa & Deborah J. Stearns-Kurosawa (2017). "Shiga Toxin Therapeutics: Beyond Neutralization". Toxins. 9 (9). doi:10.3390/toxins9090291. PMID 28925976. Unknown parameter |month= ignored (help)
  5. ↑ 5.0 5.1 Karpman, Diana; Loos, Sebastian; Tati, Ramesh; Arvidsson, Ida (2017). "Haemolytic uraemic syndrome". Journal of Internal Medicine. 281 (2): 123–148. doi:10.1111/joim.12546. ISSN 0954-6820.
  6. ↑ 6.0 6.1 Deirdra R. Terrell, Sara K. Vesely, Johanna A. Kremer Hovinga, Bernhard Lammle & James N. George (2010). "Different disparities of gender and race among the thrombotic thrombocytopenic purpura and hemolytic-uremic syndromes". American journal of hematology. 85 (11): 844–847. doi:10.1002/ajh.21833. PMID 20799358. Unknown parameter |month= ignored (help)
  7. ↑ Noris M, Remuzzi G (2005). "Hemolytic uremic syndrome". J Am Soc Nephrol. 16 (4): 1035–50. doi:10.1681/ASN.2004100861. PMID 15728781.
  8. ↑ Taylor CM, Machin S, Wigmore SJ, Goodship TH, working party from the Renal Association, the British Committee for Standards in Haematology and the British Transplantation Society (2010). "Clinical practice guidelines for the management of atypical haemolytic uraemic syndrome in the United Kingdom". Br J Haematol. 148 (1): 37–47. doi:10.1111/j.1365-2141.2009.07916.x. PMID 19821824.

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