Abstract
BACKGROUND AND OBJECTIVES
Early identification of children with Shiga toxin–producing Escherichia coli–associated hemolytic uremic syndrome (STEC-HUS) at risk of a complicated course may optimize management. The neutrophil-to-lymphocyte ratio (NLR) is a simple, widely available marker of inflammatory imbalance with prognostic value in several diseases; however, its prognostic performance in children with STEC-HUS remains unexplored.
METHODS
In this retrospective observational prognostic study, we reviewed the medical records of patients hospitalized with STEC-HUS at a tertiary hospital in Argentina between 2000 and 2024. Demographic, clinical, and laboratory variables were compared between patients with complicated (dialysis >10 days and/or extrarenal complications and/or death) and uncomplicated disease. The prognostic performance of laboratory variables was calculated using receiver operating characteristic (ROC) curve analysis.
RESULTS
Of 214 patients, 70 (32.7%) had complicated disease. Patients who developed complicated disease had significantly higher NLR values than those who did not (4.8 vs 1.4, P
CONCLUSION
The NLR demonstrated strong predictive value for a complicated disease course in children with STEC-HUS. External validation in independent cohorts is required before routine clinical implementation.