Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management
Shiga toxin-producing <i>Escherichia coli</i>-associated hemolytic uremic syndrome (STEC-HUS) is a form of thrombotic microangiopathy secondary to an infection by an enterohemorrhagic <i>E. coli</i>. Historically considered a pediatric disease, its presentation has been descr...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-04-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/13/5/306 |
| _version_ | 1797536313949290496 |
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| author | Benoit Travert Cédric Rafat Patricia Mariani Aurélie Cointe Antoine Dossier Paul Coppo Adrien Joseph |
| author_facet | Benoit Travert Cédric Rafat Patricia Mariani Aurélie Cointe Antoine Dossier Paul Coppo Adrien Joseph |
| author_sort | Benoit Travert |
| collection | DOAJ |
| description | Shiga toxin-producing <i>Escherichia coli</i>-associated hemolytic uremic syndrome (STEC-HUS) is a form of thrombotic microangiopathy secondary to an infection by an enterohemorrhagic <i>E. coli</i>. Historically considered a pediatric disease, its presentation has been described as typical, with bloody diarrhea at the forefront. However, in adults, the clinical presentation is more diverse and makes the early diagnosis hazardous. In this review, we review the epidemiology, most important outbreaks, physiopathology, clinical presentation and prognosis of STEC-HUS, focusing on the differential features between pediatric and adult disease. We show that the clinical presentation of STEC-HUS in adults is far from typical and marked by the prevalence of neurological symptoms and a poorer prognosis. Of note, we highlight knowledge gaps and the need for studies dedicated to adult patients. The differences between pediatric and adult patients have implications for the treatment of this disease, which remains a public health threat and lack a specific treatment. |
| first_indexed | 2024-03-10T11:57:57Z |
| format | Article |
| id | doaj.art-6be610ee19704061859c1c3350a3da00 |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-10T11:57:57Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-6be610ee19704061859c1c3350a3da002023-11-21T17:10:13ZengMDPI AGToxins2072-66512021-04-0113530610.3390/toxins13050306Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care ManagementBenoit Travert0Cédric Rafat1Patricia Mariani2Aurélie Cointe3Antoine Dossier4Paul Coppo5Adrien Joseph6Service de Médecine Interne, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, 75018 Paris, FranceCentre de Référence des Microangiopathies Thrombotiques (CNR-MAT), Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, 75012 Paris, FranceService de Microbiologie, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, 75019 Paris, FranceService de Microbiologie, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, 75019 Paris, FranceService de Médecine Interne, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, 75018 Paris, FranceCentre de Référence des Microangiopathies Thrombotiques (CNR-MAT), Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, 75012 Paris, FranceCentre de Référence des Microangiopathies Thrombotiques (CNR-MAT), Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, 75012 Paris, FranceShiga toxin-producing <i>Escherichia coli</i>-associated hemolytic uremic syndrome (STEC-HUS) is a form of thrombotic microangiopathy secondary to an infection by an enterohemorrhagic <i>E. coli</i>. Historically considered a pediatric disease, its presentation has been described as typical, with bloody diarrhea at the forefront. However, in adults, the clinical presentation is more diverse and makes the early diagnosis hazardous. In this review, we review the epidemiology, most important outbreaks, physiopathology, clinical presentation and prognosis of STEC-HUS, focusing on the differential features between pediatric and adult disease. We show that the clinical presentation of STEC-HUS in adults is far from typical and marked by the prevalence of neurological symptoms and a poorer prognosis. Of note, we highlight knowledge gaps and the need for studies dedicated to adult patients. The differences between pediatric and adult patients have implications for the treatment of this disease, which remains a public health threat and lack a specific treatment.https://www.mdpi.com/2072-6651/13/5/306Shiga toxin<i>Escherichia coli</i>hemolytic uremic syndromethrombotic microangiopathy |
| spellingShingle | Benoit Travert Cédric Rafat Patricia Mariani Aurélie Cointe Antoine Dossier Paul Coppo Adrien Joseph Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management Toxins Shiga toxin <i>Escherichia coli</i> hemolytic uremic syndrome thrombotic microangiopathy |
| title | Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management |
| title_full | Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management |
| title_fullStr | Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management |
| title_full_unstemmed | Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management |
| title_short | Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management |
| title_sort | shiga toxin associated hemolytic uremic syndrome specificities of adult patients and implications for critical care management |
| topic | Shiga toxin <i>Escherichia coli</i> hemolytic uremic syndrome thrombotic microangiopathy |
| url | https://www.mdpi.com/2072-6651/13/5/306 |
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