title: Red blood cell Thomsen-Friedenreich antigen expression and galectin-3 plasma concentrations in Streptococcus pneumoniae-associated hemolytic uremic syndrome and hemolytic anemia.
abstract: BACKGROUND
  Pneumococcal hemolytic uremic syndrome (P-HUS) is a rare but severe complication of invasive pneumococcal disease (IPD) in young children. Consensual biologic diagnosis criteria are currently lacking.
  
  
  METHODS
  A prospective study was conducted on 10 children with culture-confirmed IPD. Five presented with full-blown P-HUS, three had an incomplete form with hemolytic anemia and mild or no uremia (P-HA), and two had neither HUS nor HA. Thomsen-Friedenreich (T), Th, and Tk cryptantigens and sialic acid expression were determined on red blood cells (RBCs) with peanut (PNA), Glycine soja (SBA), Bandeiraea simplicifolia II, and Maackia amurensis lectins. Plasma concentrations of the major endogenous T-antigen-binding protein, galectin-3 (Gal-3), were analyzed.
  
  
  RESULTS
  We found that RBCs strongly reacted with PNA and SBA lectins in all P-HUS and P-HA patients. Three P-HUS and three P-HA patients showed also concomitant Tk activation. Direct antiglobulin test (DAT) was positive in three P-HUS (one with anti-C3d and two with anti-IgG) and two P-HA patients (one with anti-C3d and one with anti-IgG). RBCs derived from the two uncomplicated IPD patients reacted with PNA but not with SBA lectin. Gal-3 plasma concentrations were increased in all P-HUS patients.
  
  
  CONCLUSIONS
  The results indicate high levels of neuraminidase activity and desialylation in both P-HUS and P-HA patients. T-antigen activation is more sensitive than DAT for P-HUS diagnosis. Combining PNA and SBA lectins is needed to improve the specificity of T-antigen activation. High concentrations of Gal-3 in P-HUS patients suggest that Gal-3 may contribute to the pathogenesis of P-HUS.
authors.affiliation: Etablissement Français du Sang Ile de France, Villejuif, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Burin des Roziers
authors.affiliation: Etablissement Français du Sang Ile de France, Villejuif, France.|Inserm UMR955, Créteil, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Chadebech
authors.affiliation: Etablissement Français du Sang Ile de France, Villejuif, France.|Inserm UMR955, Créteil, France.
authors.forename: Gwellaouen
authors.initials: G
authors.lastname: Bodivit
authors.affiliation: Etablissement Français du Sang Rhône-Alpes, Lyon, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Guinchard
authors.affiliation: Laboratoire de Biochimie Métabolique et Cellulaire, Hôpital Bichat, Paris, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Bruneel
authors.affiliation: Laboratoire de Biochimie Métabolique et Cellulaire, Hôpital Bichat, Paris, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Dupré
authors.affiliation: Réanimation Pédiatrique, Hôpital de Bicêtre, Le Kremlin Bicêtre, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Chevret
authors.affiliation: Réanimation Chirurgicale Pédiatrique, Hôpital Necker-Enfants Malades, Paris, France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Jugie
authors.affiliation: Etablissement Français du Sang Ile de France, Villejuif, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gallon
authors.affiliation: Etablissement Français du Sang Ile de France, Villejuif, France.|Inserm UMR955, Créteil, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Bierling
authors.affiliation: Etablissement Français du Sang Ile de France, Villejuif, France.|Inserm UMR955, Créteil, France.
authors.forename: France
authors.initials: F
authors.lastname: Noizat-Pirenne
mesh_terms: D000743:Anemia, Hemolytic / Q000097:blood / Q000276:immunology / Q000382:microbiology*; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000276:immunology / Q000378:metabolism*; D003298:Coombs Test; D004912:Erythrocytes / Q000276:immunology / Q000378:metabolism*; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D006463:Hemolytic-Uremic Syndrome / Q000097:blood / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008297:Male; D009439:Neuraminidase / Q000378:metabolism; D011008:Pneumococcal Infections / Q000097:blood / Q000150:complications* / Q000276:immunology; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae / Q000502:physiology*
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D037502:Galectin 3; C016467:Thomsen-Friedenreich antigen; D009439:Neuraminidase