Pediatrics in Review
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(Pediatrics in Review. 2006;27:398-399.)
© 2006 American Academy of Pediatrics

In Brief

Hemolytic-Uremic Syndrome

The first 300 words of the full text of this article appear below.

Glomerular Disorders. Eddy A. In: Rudolph CD, ed. Rudolph’s Pediatrics. 21st ed. New York, NY: McGraw Hill; 2003:1677 –1699 Escherichia coli O157:H7 and the Hemolytic-Uremic Syndrome. Boyce TG, Swerdlow DL, Griffin PM. N Engl J Med. 1995;333 :364 –368[Free Full Text] Escherichia coli Diarrhea (Including Hemolytic-Uremic Syndrome). In: Pickering LK, ed. Red Book: 2006 Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village, Ill: American Academy of Pediatrics; 2006:291 –296 Important Bacterial Gastrointestinal Pathogens in Children: A Pathogenesis Perspective. Amieva MR. Pediatr Clin North Am. 2005;52 :749 –777[CrossRef][Medline] Hemolytic Uremic Syndrome: Pathogenesis, Treatment, and Outcome. Siegler R, Oakes R. Curr Opin Pediatr. 2005;17 :200 –204[CrossRef][Medline] Relative Nephroprotection During Escherichia coli O157:H7 Infections: Association With Intravenous Volume Expansion. Ake JA, Jelacic S, Ciol MA, et al. Pediatrics. 2005;115 :e673 –e680[Abstract/Free Full Text]

Hemolytic-uremic syndrome (HUS), the triad of microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency, is the leading cause of renal failure in the United States in previously healthy children, in particular those younger than 3 years of age. There are two broad etiologic categories: typical HUS (with diarrhea, or D+) and atypical HUS (without diarrhea, or D–). Some 90% of HUS in the United States is classified as D+, and most cases are caused by shiga-toxin-producing strains of Escherichia coli (STEC), most often the O157:H7 subtype.

Although E coli are part of the normal intestinal flora, the bacteria have acquired the ability to cause disease in the gastrointestinal (GI) tract. STEC, also called enterohemorrhagic E coli, is the only pathotype of E coli causing disease in children in the United States. The STEC pathotype is related closely to enteropathogenic E coli, the cause of traveler’s diarrhea, with the acquired ability to . . . [Full Text of this Article]


Elizabeth K. Fiorino, MD
Ryan M. Raffaelli, MD
 Children’s Hospital at Montefiore
Bronx, NY

Henry M. Adam, MD, Editor, In Brief




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