title: [Hemolytic uremic syndrome following EHEC infection].
abstract: METHODS
  We report on four patients treated for typical hemolytic uremic syndrome (HUS) at our hospital during the outbreak in Germany in May 2011. Three out of four patients had previously travelled to northern Germany, one patient was exposed within the family.
  
  
  METHODS
  All patients were tested positive for enterohemorrhagic E.coli of the type O104:H4 in stool cultures and presented with signs of thrombotic microangiopathy and fragmented erythrocytes.
  
  
  METHODS
  Due to strong hemolytic activity (LDH >600 U/l), thrombocytopenia (< 60,000/µl) und acute kidney injury (creatinine >1.2 mg/dl) plasma separation with fresh frozen plasma was commenced in three out of four patients with the fourth patient exhibiting a self-limiting course. Altogether, it took 7 to 13 treatments until disease activity was stopped. During treatment, kidney injury recovered and all patients had negative stool cultures.
  
  
  CONCLUSIONS
  The HUS-outbreak 2011 in Germany was associated with a severe course in many patients, particularly in women. Treatment with plasma separation was successful to stop hemolysis and end disease activity.
authors.affiliation: Medizinische Klinik, Universitätsklinikum Tübingen. ferruh.artunc@med.uni-tuebingen.de
authors.forename: Ferruh
authors.initials: F
authors.lastname: Artunc
authors.forename: Kerstin
authors.initials: K
authors.lastname: Amann
authors.forename: Michael
authors.initials: M
authors.lastname: Haap
mesh_terms: D000368:Aged; D001431:Bacteriological Techniques; D003131:Combined Modality Therapy; D054324:Enterohemorrhagic Escherichia coli / Q000235:genetics / Q000472:pathogenicity*; D004797:Enzyme-Linked Immunosorbent Assay; D058872:Epidemics; D004927:Escherichia coli Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy / Q000635:transmission; D005243:Feces / Q000382:microbiology; D005260:Female; D005517:Foodborne Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D006801:Humans; D007678:Kidney Glomerulus / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D022641:Shiga Toxin 2 / Q000235:genetics; D014195:Travel; D014774:Virulence; D055815:Young Adult
chemical_list: D022641:Shiga Toxin 2