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J Gastroenterol Hepatol. 2018 Jul;33(7):1353-1356. doi: 10.1111/jgh.14082. Epub 2018 Mar 12.

Anti-Shiga toxin 2 antibodies in enterohemorrhagic Escherichia coli O104:H4 infected patients may predict hemolytic uremic syndrome.

Author information

1
Center of Internal Medicine II, University Hospital Brandenburg, Brandenburg Medical School, Brandenburg, Germany.
2
Department of Anatomy and Experimental Morphology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
3
Institute of Hygiene and National Consulting Laboratory for Hemolytic Uremic Syndrome (HUS), University Hospital Münster, Münster, Germany.
4
I. Department of Medicine, Asklepios Klinik Altona, Hamburg, Germany.

Abstract

BACKGROUND AND AIM:

An outbreak of Shiga toxin 2 (Stx2) producing enterohemorrhagic and enteroaggregative Escherichia coli O104:H4 infection in May 2011 in Germany caused enterocolitis and an unprecedented high 22% rate of hemolytic uremic syndrome (HUS). We hypothesized that anti-Stx2 IgM or IgG titers might predict HUS development.

METHODS:

Thirty-two patients infected with enterohemorrhagic Escherichia coli O104:H4 (HUS: n = 23; non-HUS: n = 9) were retrospectively screened for anti-Stx2 IgM/IgG and matched with clinical data regarding HUS development, fever, superinfection, dialysis, neurological symptoms, intensive care, antibiotic treatment, and plasmapheresis.

RESULTS:

Only HUS patients showed a prominent Stx2-specific humoral response in the early acute phase. Despite a strong trend towards prediction of HUS development, statistical analysis revealed no significant correlation between high IgM/IgG titers and further key clinical parameters such as fever, superinfection, neurological symptoms, antibiotic treatment, and plasmapheresis.

CONCLUSIONS:

Anti-Stx2 antibodies seem to accompany or even precede HUS development.

KEYWORDS:

EHEC O104:H4; HUS; Shiga toxin 2; anti-Shiga toxin 2; hemolytic uremic syndrome

PMID:
29280264
DOI:
10.1111/jgh.14082
[Indexed for MEDLINE]

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