Journal of Ultrasound in Medicine, Vol 7, Issue 8 439-442, Copyright © 1988 by American Institute of Ultrasound in Medicine
Cortical echogenicity in the hemolytic uremic syndrome: clinical correlation
P. L. Choyke, E. G. Grant, F. A. Hoffer, L. Tina and S. Korec
Department of Radiology, Georgetown University Hospital, Washington, D.C.
The initial renal sonograms of 15 patients, aged 8 months to 5 years, with
hemolytic uremic syndrome (HUS) were reviewed. Ultrasound studies were
graded according to cortical echogenicity relative to the liver, they were
compared to the severity of the clinical syndrome at admission and to the
ultimate outcome of the disease. The degree of cortical echogenicity
correlated with the clinical outcome of HUS in 12 of the patients, whereas
clinical assessment alone predicted outcome in 13 patients. Sonography
overestimated severity in three patients with mild disease correctly
assessed clinically, whereas clinical assessment overestimated severity in
two patients with moderate disease in whom the sonographic assessment
proved correct. The sonographic changes are most likely multifactorial.
They appear to reflect a combination of platelet-thrombus deposition in the
renal cortex, as well as the general fluid status of the patient.
Ultrasound is useful in ruling out other causes of acute renal failure such
as obstruction or congenital diseases. It cannot replace laboratory tests
and clinical judgement, but nevertheless provides another index of severity
in patients with HUS.
