title: Incomplete hemolytic-uremic syndrome in Argentinean children with bloody diarrhea.
abstract: Argentina has an exceptionally high frequency of hemolytic-uremic syndrome (HUS). We sought to define prospectively the role of verocytotoxins (Shiga-like toxins [SLTs]) in 254 Argentinean children with grossly bloody diarrhea during spring and summer. Free fecal SLTs (I/II) and/or DNA probe-positive isolates were found in 99 (39%) of the children. During the follow-up period, HUS developed in 6 patients (4 with evidence of recent SLT infection based on stool studies); another 14 patients had some, but not all, of the abnormalities seen in typical HUS. The development of HUS or incomplete HUS in these children was significantly associated with recent SLT-Escherichia coli infection (p = 0.024). The high incidence of SLT-associated bloody diarrhea in Argentina explains, at least partially, the unusually high frequency of HUS. Our data indicate that incomplete forms of HUS may be common in patients with SLT-associated bloody diarrhea.
authors.affiliation: Department of Pediatric Infectious Diseases, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina.
authors.forename: E L
authors.initials: EL
authors.lastname: López
authors.forename: M M
authors.initials: MM
authors.lastname: Contrini
authors.forename: S
authors.initials: S
authors.lastname: Devoto
authors.forename: M F
authors.initials: MF
authors.lastname: de Rosa
authors.forename: M G
authors.initials: MG
authors.lastname: Graña
authors.forename: L
authors.initials: L
authors.lastname: Aversa
authors.forename: H F
authors.initials: HF
authors.lastname: Gómez
authors.forename: M H
authors.initials: MH
authors.lastname: Genero
authors.forename: T G
authors.initials: TG
authors.lastname: Cleary
mesh_terms: D001118:Argentina / Q000453:epidemiology; D001427:Bacterial Toxins / Q000032:analysis; D001772:Blood Cell Count; D016009:Chi-Square Distribution; D002675:Child, Preschool; D003603:Cytotoxins / Q000032:analysis; D004269:DNA, Bacterial / Q000235:genetics; D003967:Diarrhea / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D003968:Diarrhea, Infantile / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D004926:Escherichia coli / Q000235:genetics / Q000302:isolation & purification; D005243:Feces / Q000737:chemistry / Q000382:microbiology; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009693:Nucleic Acid Hybridization; D011446:Prospective Studies; D022603:Shiga Toxins
chemical_list: D001427:Bacterial Toxins; D003603:Cytotoxins; D004269:DNA, Bacterial; D022603:Shiga Toxins