Epidemiology and Infection

Original Papers

Clinical surveillance of thrombotic microangiopathies in Scotland, 2003–2005

K. G. J. POLLOCKa1 c1, D. YOUNGa1, T. J. BEATTIEa2 and W. T. A. TODDa3

a1 Health Protection Scotland, Glasgow, Scotland, UK

a2 Renal Unit, Yorkhill Hospital, Glasgow, Scotland, UK

a3 Infectious Diseases Unit, Monklands Hospital, Airdrie, Scotland, UK

SUMMARY

The prevalence, incidence and outcomes of haemolytic uraemic syndrome (HUS) and thrombotic thrombocytopaenic purpura (TTP) are not well established in adults or children from prospective studies. We sought to identify both outcomes and current management strategies using prospective, national surveillance of HUS and TTP, from 2003 to 2005 inclusive. We also investigated the links between these disorders and factors implicated in the aetiology of HUS and TTP including infections, chemotherapy, and immunosuppression. Most cases of HUS were caused by verocytotoxin-producing Escherichia coli (VTEC), of which serotype O157 predominated, although other serotypes were identified. The list of predisposing factors for TTP was more varied although use of immunosuppressive agents and severe sepsis, were the most frequent precipitants. The study demonstrates 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 epidemiological profiling for these disorders.

(Accepted January 31 2007)

(Online publication March 05 2007)

Correspondence:

c1 Author for correspondence: Dr K. G. J. Pollock, Health Protection Scotland, Clifton House, Clifton Place, Glasgow, UK. (Email: Kevin.Pollock@hps.scot.nhs.uk)

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