title: Role of non-polio enterovirus infection in pediatric hemolytic uremic syndrome.
abstract: Verocytotoxin-producing Escherichia coli(VTEC) infections cause most cases of hemolytic uremic syndrome (HUS); 10-30% of patients, however, are negative for VTEC infection. The etiology of HUS in VTEC-negative cases remains poorly understood. Before the association between VTEC infection and HUS was recognized, sporadic cases of HUS with enterovirus infection were reported in the literature. Since May 1988, most cases of HUS in Italy have been reported to the Italian surveillance system, and in 73% of these, evidence of VTEC infection was demonstrated. The aim of this study was to determine whether the frequency of enteroviral infections was different in the acute phase of VTEC-positive and VTEC-negative HUS. Eighty-nine patients were investigated for enteroviral infection, of whom 58 were VTEC positive and 31 VTEC negative. Two serum samples from each patient were examined for seroconversion to enterovirus (coxsackie, echovirus, and picornavirus) by a complement fixation test. Serological evidence of acute infection with non-polio enterovirus was found in 33 patients (37%) [20/58 (34.5%) VTEC positive and 13/31 (41.9%) VTEC negative]. There was no statistically significant difference between the two groups. These results demonstrate that there are no significant differences for enteroviral infection in VTEC-positive and VTEC-negative patients and, therefore, enteroviral infections should not be considered a cause of HUS in VTEC-negative children.
authors.affiliation: Division of Nephrology and Dialysis, Bambino Gesù Children's Research Hospital and Institute for Scientific Research, Piazza Sant'Onofrio 4, 00165 Rome, Italy. lauradepetris@hotmail.com
authors.forename: Laura
authors.initials: L
authors.lastname: De Petris
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gianviti
authors.forename: Daniela
authors.initials: D
authors.lastname: Caione
authors.forename: Daniele
authors.initials: D
authors.lastname: Innocenzi
authors.forename: Alberto
authors.initials: A
authors.lastname: Edefonti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Montini
authors.forename: Tommaso
authors.initials: T
authors.lastname: De Palo
authors.forename: Alberto Eugenio
authors.initials: AE
authors.lastname: Tozzi
authors.forename: Alfredo
authors.initials: A
authors.lastname: Caprioli
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Rizzoni
mesh_terms: D002648:Child; D002675:Child, Preschool; D003168:Complement Fixation Tests; D003384:Coxsackievirus Infections / Q000150:complications / Q000821:virology; D004457:Echovirus Infections / Q000150:complications / Q000821:virology; D004769:Enterovirus Infections / Q000150:complications* / Q000821:virology; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies