scholarly journals Shiga-Toxin E. coli Hemolytic Uremic Syndrome: Review of Management and Long-term Outcome

2020 ◽  
Vol 8 (1) ◽  
pp. 16-25 ◽  
Author(s):  
V. J. Harkins ◽  
D. A. McAllister ◽  
B. C. Reynolds
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Shiga Toxin ◽  
Term Outcome ◽  
Long Term Outcome ◽  
E Coli ◽  
Uremic Syndrome

scholarly journals Favorable Long-Term Outcome after Liver-Kidney Transplant for Recurrent Hemolytic Uremic Syndrome Associated with a Factor H Mutation

2006 ◽  
Vol 6 (8) ◽  
pp. 1948-1952 ◽  
Author(s):  
J. M. Saland ◽  
S. H. Emre ◽  
B. L. Shneider ◽  
C. Benchimol ◽  
S. Ames ◽  
...  
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Kidney Transplant ◽  
Factor H ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Uremic Syndrome ◽  
Factor H Mutation

Long-term outcome and prognostic indicators in the hemolytic-uremic syndrome

1991 ◽  
Vol 118 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Richard L. Siegler ◽  
Mark K. Milligan ◽  
Ted H. Burningham ◽  
Ryan D. Christofferson ◽  
Shien-Young Chang ◽  
...  
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Prognostic Indicators ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Uremic Syndrome

scholarly journals Neurodevelopmental long-term outcome in children after hemolytic uremic syndrome

2014 ◽  
Vol 30 (3) ◽  
pp. 503-513 ◽  
Author(s):  
Kathrin Buder ◽  
Beatrice Latal ◽  
Samuel Nef ◽  
Thomas J. Neuhaus ◽  
Guido F. Laube ◽  
...  
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Uremic Syndrome

Long-term outcome of diarrhea-associated hemolytic uremic syndrome is poorly related to markers of kidney injury at 1-year follow-up in a population-based cohort

2018 ◽  
Vol 34 (4) ◽  
pp. 657-662 ◽  
Author(s):  
Catherine Monet-Didailler ◽  
Astrid Godron-Dubrasquet ◽  
Iona Madden ◽  
Yahsou Delmas ◽  
Brigitte Llanas ◽  
...  
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Kidney Injury ◽  
Population Based ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Uremic Syndrome

Clinical characteristics and long-term outcome of diarrhea-associated hemolytic uremic syndrome: a single center experience

2017 ◽  
Vol 21 (5) ◽  
pp. 889-894 ◽  
Author(s):  
Takeshi Ninchoji ◽  
Kandai Nozu ◽  
Keita Nakanishi ◽  
Tomoko Horinouchi ◽  
Junya Fujimura ◽  
...  
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Clinical Characteristics ◽  
Single Center ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Single Center Experience ◽  
Uremic Syndrome

scholarly journals Neurological involvement in children with hemolytic uremic syndrome

2021 ◽  
Author(s):  
Caoimhe Costigan ◽  
Tara Raftery ◽  
Anne G. Carroll ◽  
Dermot Wildes ◽  
Claire Reynolds ◽  
...  
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Case Fatality Rate ◽  
Clinical Presentation ◽  
Case Fatality ◽  
Neurological Involvement ◽  
Fatality Rate ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Uremic Syndrome

AbstractOur objective was to establish the rate of neurological involvement in Shiga toxin-producing Escherichia coli–hemolytic uremic syndrome (STEC-HUS) and describe the clinical presentation, management and outcome. A retrospective chart review of children aged ≤ 16 years with STEC-HUS in Children’s Health Ireland from 2005 to 2018 was conducted. Laboratory confirmation of STEC infection was required for inclusion. Neurological involvement was defined as encephalopathy, focal neurological deficit, and/or seizure activity. Data on clinical presentation, management, and outcome were collected. We identified 240 children with HUS; 202 had confirmed STEC infection. Neurological involvement occurred in 22 (11%). The most common presentation was seizures (73%). In the neurological group, 19 (86%) were treated with plasma exchange and/or eculizumab. Of the 21 surviving children with neurological involvement, 19 (91%) achieved a complete neurological recovery. A higher proportion of children in the neurological group had renal sequelae (27% vs. 12%, P = .031). One patient died from multi-organ failure.Conclusion: We have identified the rate of neurological involvement in a large cohort of children with STEC-HUS as 11%. Neurological involvement in STEC-HUS is associated with good long-term outcome (complete neurological recovery in 91%) and a low case-fatality rate (4.5%) in our cohort. What is Known:• HUS is associated with neurological involvement in up to 30% of cases.• Neurological involvement has been reported as predictor of poor outcome, with associated increased morbidity and mortality. What is New:• The incidence of neurological involvement in STEC-HUS is 11%.• Neurological involvement is associated with predominantly good long-term outcome (90%) and a reduced case-fatality rate (4.5%) compared to older reports.

scholarly journals Hemoconcentration and predictors in Shiga toxin-producing E. coli-hemolytic uremic syndrome (STEC-HUS)

2021 ◽  
Author(s):  
Sebastian Loos ◽  
Jun Oh ◽  
Laura van de Loo ◽  
Markus J. Kemper ◽  
Martin Blohm ◽  
...  
Keyword(s):  
Risk Factor ◽  
Serum Creatinine ◽  
Hemolytic Uremic Syndrome ◽  
Shiga Toxin ◽  
Neurological Symptoms ◽  
Fluid Loss ◽  
Good Prediction ◽  
E Coli ◽  
Complicated Course ◽  
Uremic Syndrome

Abstract Background Hemoconcentration has been identified as a risk factor for a complicated course in Shiga toxin-producing E. coli-hemolytic uremic syndrome (STEC-HUS). This single-center study assesses hemoconcentration and predictors at presentation in STEC-HUS treated from 2009–2017. Methods Data of 107 pediatric patients with STEC-HUS were analyzed retrospectively. Patients with mild HUS (mHUS, definition: max. serum creatinine < 1.5 mg/dL and no major neurological symptoms) were compared to patients with severe HUS (sHUS, definition: max. serum creatinine ≥ 1.5 mg/dL ± major neurological symptoms). Additionally, predictors of complicated HUS (dialysis ± major neurological symptoms) were analyzed. Results Sixteen of one hundred seven (15%) patients had mHUS. Admission of patients with sHUS occurred median 2 days earlier after the onset of symptoms than in patients with mHUS. On admission, patients with subsequent sHUS had significantly higher median hemoglobin (9.5 g/dL (3.6–15.7) vs. 8.5 g/dL (4.2–11.5), p = 0.016) than patients with mHUS. The product of hemoglobin (g/dL) and LDH (U/L) (cutoff value 13,302, sensitivity 78.0%, specificity of 87.5%) was a predictor of severe vs. mild HUS. Creatinine (AUC 0.86, 95% CI 0.79–0.93) and the previously published score hemoglobin (g/dL) + 2 × creatinine (mg/dL) showed a good prediction for development of complicated HUS (AUC 0.87, 95% CI 0.80–0.93). Conclusions At presentation, patients with subsequent severe STEC-HUS had a higher degree of hemoconcentration. This underlines that fluid loss or reduced fluid intake/administration may be a risk factor for severe HUS. The good predictive value of the score hemoglobin (g/dL) + 2 × creatinine (mg/dL) for complicated HUS could be validated in our cohort. Graphical abstract

Outbreak of Shiga Toxin–Producing Escherichia coli (STEC) O104:H4 Infection in Germany Causes a Paradigm Shift with Regard to Human Pathogenicity of STEC Strains

2012 ◽  
Vol 75 (2) ◽  
pp. 408-418 ◽  
Author(s):  
LOTHAR BEUTIN ◽  
ANNETT MARTIN
Keyword(s):  
Escherichia Coli ◽  
Hemolytic Uremic Syndrome ◽  
Shiga Toxin ◽  
Outbreak Strain ◽  
Fenugreek Seeds ◽  
E Coli ◽  
Aggregative Adherence ◽  
Uremic Syndrome ◽  
Enterocyte Effacement ◽  
The Way

An outbreak that comprised 3,842 cases of human infections with enteroaggregative hemorrhagic Escherichia coli (EAHEC) O104:H4 occurred in Germany in May 2011. The high proportion of adults affected in this outbreak and the unusually high number of patients that developed hemolytic uremic syndrome makes this outbreak the most dramatic since enterohemorrhagic E. coli (EHEC) strains were first identified as agents of human disease. The characteristics of the outbreak strain, the way it spread among humans, and the clinical signs resulting from EAHEC infections have changed the way Shiga toxin–producing E. coli strains are regarded as human pathogens in general. EAHEC O104:H4 is an emerging E. coli pathotype that is endemic in Central Africa and has spread to Europe and Asia. EAHEC strains have evolved from enteroaggregative E. coli by uptake of a Shiga toxin 2a (Stx2a)–encoding bacteriophage. Except for Stx2a, no other EHEC-specific virulence markers including the locus of enterocyte effacement are present in EAHEC strains. EAHEC O104:H4 colonizes humans through aggregative adherence fimbrial pili encoded by the enteroaggregative E. coli plasmid. The aggregative adherence fimbrial colonization mechanism substitutes for the locus of enterocyte effacement functions for bacterial adherence and delivery of Stx2a into the human intestine, resulting clinically in hemolytic uremic syndrome. Humans are the only known natural reservoir known for EAHEC. In contrast, Shiga toxin–producing E. coli and EHEC are associated with animals as natural hosts. Contaminated sprouted fenugreek seeds were suspected as the primary vehicle of transmission of the EAHEC O104:H4 outbreak strain in Germany. During the outbreak, secondary transmission (human to human and human to food) was important. Epidemiological investigations revealed fenugreek seeds as the source of entry of EAHEC O104:H4 into the food chain; however, microbiological analysis of seeds for this pathogen produced negative results. The survival of EAHEC in seeds and the frequency of human carriers of EAHEC should be investigated for a better understanding of EAHEC transmission routes.

scholarly journals Circulating microRNAs in Patients with Shiga-Toxin-Producing E. coli O104:H4 Induced Hemolytic Uremic Syndrome

PLoS ONE ◽  
2012 ◽  
Vol 7 (10) ◽  
pp. e47215 ◽  
Author(s):  
Johan M. Lorenzen ◽  
Jan Menne ◽  
Bernhard MW. Schmidt ◽  
Mascha Schmidt ◽  
Filippo Martino ◽  
...  
Keyword(s):  
Hemolytic Uremic Syndrome ◽  
Shiga Toxin ◽  
Circulating Micrornas ◽  
E Coli ◽  
Uremic Syndrome
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