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Semin Thromb Hemost. 2014 Jun;40(4):478-86. doi: 10.1055/s-0034-1376154. Epub 2014 May 15.

Diagnosis and treatment of the hemolytic uremic syndrome disease spectrum in developing regions.

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Department of Pediatrics I, Innsbruck Medical University, Innsbruck, Austria.
Center for Pediatric Nephrology and Transplantation, Department of Pediatrics, Kasr Alainy Faculty of Medicine, Cairo University, Egypt.


There has been rapid progress in the understanding of the pathophysiology of the hemolytic uremic syndrome (HUS) disease spectrum; thus, complex diagnostic and therapeutic requirements have emerged in parallel. Current recommendations for diagnosis and therapy were rapidly adapted from the prior skilled scientific groundwork. However, such recommendations can be realized only when highly specialized laboratories and sufficient financial resources are available. Thus, many recommendations are not feasible for patients living and working in developing countries. More than one-third of the world's population has no access to essential drugs and more than half of this group lives in the poorest regions of Africa and Asia. From this perspective, distinct initial diagnostic and therapeutic recommendations, as well as international cooperations are needed to complete proper diagnostic work-ups in a stringent and cost-efficient manner and to enable patients to be adequately treated with available resources. However, while costs for complement-targeted drugs remain tremendously high, state-of-the-art treatment options remain unavailable for the vast majority of patients in developing areas.

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