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Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management

Shiga toxin-producing Escherichia coli-associated hemolytic uremic syndrome (STEC-HUS) is a form of thrombotic microangiopathy secondary to an infection by an enterohemorrhagic E. coli. Historically considered a pediatric disease, its presentation has been described as typical, with bloody diarrhea...

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Autores principales: Travert, Benoit, Rafat, Cédric, Mariani, Patricia, Cointe, Aurélie, Dossier, Antoine, Coppo, Paul, Joseph, Adrien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145702/
https://www.ncbi.nlm.nih.gov/pubmed/33925836
http://dx.doi.org/10.3390/toxins13050306
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author Travert, Benoit
Rafat, Cédric
Mariani, Patricia
Cointe, Aurélie
Dossier, Antoine
Coppo, Paul
Joseph, Adrien
author_facet Travert, Benoit
Rafat, Cédric
Mariani, Patricia
Cointe, Aurélie
Dossier, Antoine
Coppo, Paul
Joseph, Adrien
author_sort Travert, Benoit
collection PubMed
description Shiga toxin-producing Escherichia coli-associated hemolytic uremic syndrome (STEC-HUS) is a form of thrombotic microangiopathy secondary to an infection by an enterohemorrhagic E. coli. Historically considered a pediatric disease, its presentation has been described as typical, with bloody diarrhea at the forefront. However, in adults, the clinical presentation is more diverse and makes the early diagnosis hazardous. In this review, we review the epidemiology, most important outbreaks, physiopathology, clinical presentation and prognosis of STEC-HUS, focusing on the differential features between pediatric and adult disease. We show that the clinical presentation of STEC-HUS in adults is far from typical and marked by the prevalence of neurological symptoms and a poorer prognosis. Of note, we highlight knowledge gaps and the need for studies dedicated to adult patients. The differences between pediatric and adult patients have implications for the treatment of this disease, which remains a public health threat and lack a specific treatment.
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spelling pubmed-81457022021-05-26 Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management Travert, Benoit Rafat, Cédric Mariani, Patricia Cointe, Aurélie Dossier, Antoine Coppo, Paul Joseph, Adrien Toxins (Basel) Review Shiga toxin-producing Escherichia coli-associated hemolytic uremic syndrome (STEC-HUS) is a form of thrombotic microangiopathy secondary to an infection by an enterohemorrhagic E. coli. Historically considered a pediatric disease, its presentation has been described as typical, with bloody diarrhea at the forefront. However, in adults, the clinical presentation is more diverse and makes the early diagnosis hazardous. In this review, we review the epidemiology, most important outbreaks, physiopathology, clinical presentation and prognosis of STEC-HUS, focusing on the differential features between pediatric and adult disease. We show that the clinical presentation of STEC-HUS in adults is far from typical and marked by the prevalence of neurological symptoms and a poorer prognosis. Of note, we highlight knowledge gaps and the need for studies dedicated to adult patients. The differences between pediatric and adult patients have implications for the treatment of this disease, which remains a public health threat and lack a specific treatment. MDPI 2021-04-26 /pmc/articles/PMC8145702/ /pubmed/33925836 http://dx.doi.org/10.3390/toxins13050306 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Travert, Benoit
Rafat, Cédric
Mariani, Patricia
Cointe, Aurélie
Dossier, Antoine
Coppo, Paul
Joseph, Adrien
Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management
title Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management
title_full Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management
title_fullStr Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management
title_full_unstemmed Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management
title_short Shiga Toxin-Associated Hemolytic Uremic Syndrome: Specificities of Adult Patients and Implications for Critical Care Management
title_sort shiga toxin-associated hemolytic uremic syndrome: specificities of adult patients and implications for critical care management
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145702/
https://www.ncbi.nlm.nih.gov/pubmed/33925836
http://dx.doi.org/10.3390/toxins13050306
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