Pathogenesis of Shiga toxin-induced hemolytic uremic syndrome

Shiga Toxin Activates Complement and Binds Factor H: Evidence for an Active Role of Complement in Hemolytic Uremic Syndrome

“…Pathogenesis of EHEC-induced HUS has not yet been fully elucidated; however, Stx has been found to damage endothelial and epithelial cells by inhibition of protein synthesis and apoptosis (18). Activation of the complement cascade as shown in this study also results in destruction of the kidney and other organs, not only by direct lysis of cells, but also via the release of chemotactic anaphylatoxins C3a and C5a (9).…”

Campylobacter-Associated Hemolytic Uremic Syndrome Associated with Pulmonary-Renal Syndrome

“…2,4 D+HUS is much more common in children than adults, due to high expression of Stx receptors in their renal glomeruli. 5 Therefore, adult cases tend to be sporadic or in association with outbreaks of E.coli infection, such as that reported in Germany in 2011. 6 Adult D+HUS is thought to have the same etiology and pathogenesis as childhood D+HUS, but is more likely to have severe clinical sequelae; such as chronic proteinuria, hypertension, end-stage renal failure and higher mortality rates.…”

Hemolytic Uremic Syndrome

“…Intravascular hemolysis leads to reduction of haptoglobin due to its binding with released haemoglobin. Urine routine analysis reveals hemoglobinuria, hematuria, and mild protinuria [22,23]. The degree of renal insufficiency, which is nearly always presents, varies and is determined by evidence of raised serum urea, creatinine, phosphate and potassium.…”

“…The classical D+ HUS has less than 5% mortality with good supportive care in most medical centres. Although the long term outcome is also better in these patients than other form of HUS, up to 10-30% patients develop chronic kidney disease and nearly 5-10% of these patients develop end stage renal disease (ESRD) in the next 10 years [27,22]. The prognosis for D-HUS is worse.…”