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- Elizabeth K. Fiorino, MD
- Ryan M. Raffaelli, MD
- Children’s Hospital at Montefiore
Bronx, NY
Hemolytic-uremic syndrome (HUS), the triad of microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency, is the leading cause of renal failure in the United States in previously healthy children, in particular those younger than 3 years of age. There are two broad etiologic categories: typical HUS (with diarrhea, or D+) and atypical HUS (without diarrhea, or D−). Some 90% of HUS in the United States is classified as D+, and most cases are caused by shiga-toxin-producing strains of Escherichia coli (STEC), most often the O157:H7 subtype.
Although E coli are part of the normal intestinal flora, the bacteria have acquired the ability to cause disease in the gastrointestinal (GI) tract. STEC, also called enterohemorrhagic E coli, is the only pathotype of E coli causing disease in children in the United States. The STEC pathotype is related closely to enteropathogenic E coli, the cause of traveler’s diarrhea, with …
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