Epidemiology
TMA, which includes HUS and TTP are rare disorders, although their incidence is not well established in either children (where HUS is commoner) or adults (where TTP is commoner). HUS is one of the most common causes of acute kidney failure in childhood worldwide and has a number of aetiologies including several infectious agents, the most common of these being Escherichia coli O157.
Main clinical features
Thrombotic microangiopathies are rare, systemic disorders characterized by red blood cell destruction, micro-thrombosis, and multi-organ injury often involving renal and/or neurological complications.
Surveillance
Voluntary reports of TMA are sent to HPS from collaborating clinicians via “ENSHURE†(Enhanced surveillance of HUS and other thrombotic microangiopathies). Clinical surveillance is particularly relevant in Scotland, where consistently higher rates of infection with E. coli O157 have been reported than in other parts of the UK or Europe. Through ENSHURE, we seek to identify both outcomes and current management strategies using prospective, national surveillance of HUS, TTP and other microangiopathies. We investigate the links between these disorders and factors implicated in the aetiology of HUS and TTP including infections, chemotherapy, and immuno-suppression. So far, the study has demonstrated that while differentiating between HUS and TTP is sometimes difficult, in most cases the two syndromes have quite different predisposing factors and clinical parameters, enabling clinical and epidemiologic profiling for these disorders.
Useful Links
- Clinical surveillance paper submitted to Epidemiology & Infection
- Tarr pdf on treatment of VTEC/HUS patients
- 3rd year annual report pdf (has surveillance data)
- HUSH – the E. coli support group (http://www.ecoli-uk.com/)
Last reviewed: 06 March 2007
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