Leukocytosis in children with Escherichia coli O157:H7 enteritis developing the hemolytic-uremic syndrome

Buteau, Chantal; Proulx, François; Chaïbou, M; Raymond, Didier; Clermont, Marie‐José; Mariscalco, Michele; LeBel, Marc; Seidman, E. G.

doi:10.1097/00006454-200007000-00012

Cited by 56 publications

(37 citation statements)

References 26 publications

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“…Because observational studies are prone to finding false associations, 15 the reproducibility of findings in different observational studies improves scientific evidence. 16 Similar to others who have found a dose-response relationship between degree of leukocytosis in children with STEC O157 infections and the likelihood of developing D + HUS, 17 we found an association of increasing WBC count with increased probability of death.…”

Section: Discussionsupporting

confidence: 89%

Postdiarrheal Hemolytic Uremic Syndrome in United States Children: Clinical Spectrum and Predictors of In-Hospital Death

Mody¹,

Gu²,

Griffin³

et al. 2015

The Journal of Pediatrics

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Section: Discussionsupporting

confidence: 89%

Postdiarrheal Hemolytic Uremic Syndrome in United States Children: Clinical Spectrum and Predictors of In-Hospital Death

Mody¹,

Gu²,

Griffin³

et al. 2015

The Journal of Pediatrics

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“…HUS is frequently associated with circulating leukocytosis (114 -125). Furthermore, this has been shown to be an independent risk factor for developing HUS (114,116,117). Increased circulating neutrophil (119, 120) and macrophage (120) counts are associated with the severity of renal failure during HUS.…”

Section: Host Responsementioning

confidence: 99%

Pathogenesis of Shiga Toxin-Associated Hemolytic Uremic Syndrome

2001

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“…The lack of serial measurements before and after the development of Dϩ HUS constitutes a major limitation of our study as it precludes to calculation of diagnostic predictive values. We acknowledge that few children with Dϩ HUS had blood samples drawn during the period of highest risk for the development of Dϩ HUS, which is around 3-4 d after the onset of enteric symptoms (27,28). In this regard, a slightly increased PCT level (1.9 g/L) was noted 3 d after the onset of enteritis in one patient with uncomplicated O157:H7 HC.…”

Section: Discussionmentioning

confidence: 93%

Procalcitonin in Children with Escherichia coli O157:H7 Associated Hemolytic Uremic Syndrome

et al. 2006

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Shiga toxin producing Escherichia coli (STEC) are noninvasive enteric pathogens that may cause hemorrhagic colitis (HC) and diarrhea-associated hemolytic uremic syndrome (Dϩ HUS). We hypothesized that development of Dϩ HUS is associated with increased serum procalcitonin (PCT) levels. PCT was measured by an immunoluminometric assay in 113 patients. Concentrations of PCT were different in normal controls, disease control groups (rotavirus enteritis, HC due to non-STEC pathogens, chronic renal failure), and children with uncomplicated O157:H7 HC or Dϩ HUS. Children with Dϩ HUS showed higher PCT levels than those with uncomplicated O157:H7 HC, and increased concentrations were noted in cases requiring peritoneal dialysis. Severely increased concentrations were observed in children with Dϩ HUS on d 5 or 6 after the onset of enteritis, whereas serial measurements in those with uncomplicated O157:H7 HC remained within the normal range throughout the first week of illness. PCT was correlated with serum concentrations of lipopolysaccharide (LPS)-binding protein and serum levels of alanine aminotransferase. Using two separate sets of real-time PCR primers, we were unable to detect elevated PCT mRNA transcripts in nonadherent undifferentiated (monocytic) or differentiated (macrophage-like) THP-1 cells stimulated with purified Shiga toxin-1 and/or LPS. Our data show that serum levels of PCT are associated with the severity of illness in children with Dϩ HUS. Further studies are needed to determine the role of PCT in the pathogenesis of thrombotic microangiopathy associated to childhood Dϩ HUS. (Pediatr Res 59: 579-583, 2006)

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Leukocytosis in children with Escherichia coli O157:H7 enteritis developing the hemolytic-uremic syndrome

Abstract: Based on the variables identified above, further studies are needed to determine whether the inflammatory response of the host represents only a marker of the severity of gastrointestinal infection or whether, alternatively, it is a pathophysiologic factor that leads to HUS.

Cited by 56 publications

References 26 publications

Postdiarrheal Hemolytic Uremic Syndrome in United States Children: Clinical Spectrum and Predictors of In-Hospital Death

Postdiarrheal Hemolytic Uremic Syndrome in United States Children: Clinical Spectrum and Predictors of In-Hospital Death

Pathogenesis of Shiga Toxin-Associated Hemolytic Uremic Syndrome

Procalcitonin in Children with Escherichia coli O157:H7 Associated Hemolytic Uremic Syndrome

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