Hemolytic Uremic Syndrome Associated with Invasive Pneumococcal Disease: The United Kingdom Experience

Waters, Aoife; Kerecuk, Larissa; Luk, David C K; Haq, Mushfequr R.; Fitzpatrick, Mark; Gilbert, Rodney D.; Inward, Carol; Jones, Caroline; Pichon, Bruno; Reid, C.; Slack, Mary; Hoff, William van’t; Dillon, Michael J.; Taylor, Carol M.; Tullus, Kjell

doi:10.1016/j.jpeds.2007.03.055

Cited by 161 publications

(158 citation statements)

References 41 publications

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“…Infection with VTEC such as E. coli O157 is recognized to be the predominating risk factor for D1HUS, with serotype O157 being the most common [1]. Pneumococcal-HUS is also a well-recognized etiologic factor in pediatric patients [23]. However, other studies have previously shown that there may be a role for other pathogens as potential triggers of TMA [24,25] and studies with animal models of TTP have also suggested this [14].…”

Section: Discussionmentioning

confidence: 99%

Infection frequently triggers thrombotic microangiopathy in patients with preexisting risk factors: A single‐institution experience

Douglas

Pollock

Young

et al. 2010

J of Clinical Apheresis

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Thrombotic microangiopathies are rare conditions characterized by microangiopathic hemolytic anemia, microthrombi, and multiorgan insult. The disorders, which include hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, are often acute and life threatening. We report a retrospective analysis of 65 patients presenting to our institution from 1997 to 2008 with all forms of thrombotic microangiopathy. Therapeutic plasma exchange was a requirement for analysis and 65 patients were referred to our institution; 66% of patients were female and median age at presentation was 52 years. Bacterial infection was the most commonly identified etiologic factor and in the multivariate model was the only significant variable associated with survival outcome (odds ratio 5.1, 95% confidence interval, 1.2-21.7). As infection can be considered a common trigger event for thrombotic microangiopathy, patients with hepatobiliary sepsis may benefit from elective cholecystectomy. We conclude that bacterial infection frequently triggers TTP and other thrombotic microangiopathies in patients with preexisting risk factors and propose a model for the development of these syndromes. J. Clin. Apheresis 25:47-53, 2010. V V C 2010 Wiley-Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Infection frequently triggers thrombotic microangiopathy in patients with preexisting risk factors: A single‐institution experience

Douglas

Pollock

Young

et al. 2010

J of Clinical Apheresis

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“…Streptococcus pneumoniae may cause a rare and severe infectious form of HUS, without diarrhea (SPA-HUS) [41] .…”

Section: Infectious Hus Not Diarrhea Associatedmentioning

confidence: 99%

Update on hemolytic uremic syndrome: Diagnostic and therapeutic recommendations

Salvadori

Bertoni²

2013

WJN

114

111

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Hemolytic uremic syndrome (HUS) is a rare disease. In this work the authors review the recent findings on HUS, considering the different etiologic and pathogenetic classifications. New findings in genetics and, in particular, mutations of genes that encode the complement-regulatory proteins have improved our understanding of atypical HUS. Similarly, the complement proteins are clearly involved in all types of thrombotic microangiopathy: typical HUS, atypical HUS and thrombotic thrombocytopenic purpura (TTP). Furthermore, several secondary HUS appear to be related to abnormalities in complement genes in predisposed patients. The authors highlight the therapeutic aspects of this rare disease, examining both "traditional therapy" (including plasma therapy, kidney and kidneyliver transplantation) and "new therapies". The latter include anti-Shiga-toxin antibodies and anti-C5 monoclonal antibody "eculizumab". Eculizumab has been recently launched for the treatment of the atypical HUS, but it appears to be effective in the treatment of typical HUS and in TTP. Future therapies are in phases Ⅰ and Ⅱ. They include anti-C5 antibodies, which are more purified, less immunogenic and absorbed orally and, anti-C3 antibodies, which are more powerful, but potentially less safe. Additionally, infusions of recombinant complement-regulatory proteins are a potential future therapy.

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“…A plazmaterápiával kapcsolatban kontrollált tanulmányok nem állnak rendelkezés-re. A patogenezis alapján a plazmaterápia (FFP-infúzió vagy FFP-szubsztitúcióval végzett plazmacsere) kerülen-dő az akut szakban, helyette albuminszubsztitúcióval végzett plazmacsere lehet hatásos [70][71][72]. Az a ferezistől várható haszon és a lehetséges mellékhatások, szö-vődmények egyéni mérlegelést igényelnek.…”

Section: Ajánlás 33unclassified

Egészségügyi szakmai irányelv – A thromboticus thrombocytopeniás purpura (TTP) és a haemolyticus uraemiás syndroma (HUS) kezeléséről

…¹

2017

Orvosi Hetilap

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Hemolytic Uremic Syndrome Associated with Invasive Pneumococcal Disease: The United Kingdom Experience

Cited by 161 publications

References 41 publications

Infection frequently triggers thrombotic microangiopathy in patients with preexisting risk factors: A single‐institution experience

Infection frequently triggers thrombotic microangiopathy in patients with preexisting risk factors: A single‐institution experience

Update on hemolytic uremic syndrome: Diagnostic and therapeutic recommendations

Egészségügyi szakmai irányelv – A thromboticus thrombocytopeniás purpura (TTP) és a haemolyticus uraemiás syndroma (HUS) kezeléséről

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