Outbreak of Shiga toxin-producing Escherichia-coli-associated hemolytic uremic syndrome in Istanbul in 2015: outcome and experience with eculizumab

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Ayşe AğbaşSalim Çalışkan

Abstract

This study aims to identify epidemiological and clinical characteristics of patients and report our experience with eculizumab treatment during an outbreak of hemolytic uremic syndrome (HUS) caused by Shiga toxin-producing Escherichia coli (STEC) in Istanbul in 2015. Thirty-two children (21 females, median age 3.25 years) were included in this study. Demographic, clinical and laboratory data, and treatment details were retrospectively collected. Renal outcomes were assessed at last follow-up visit. To assess the effect of eculizumab on prognosis of STEC-HUS, subgroup analysis was performed on patients who required dialysis. A high number of cases occurred within a certain region of Istanbul. Stool samples were cultured from 21 patients (65%), and enteroaggregative E. coli (EAEC; n = 7) and enterohemorrhagic E. coli (EHEC; n = 3) strains were detected. Rates of dialysis treatment, neurological manifestations, and death were 59%, 25%, and 3%, respectively. Mean follow-up duration was 8.6 ± 2.6 months (range 3-12 months). None of the patients (n = 25) was on dialysis at the final visit. The complete renal recovery rate was 54%. Nine patients were treated with eculizumab. At final follow-up visit, no differences in estimated glomer...Continue Reading

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Citations

Sep 3, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Alejandro BalestracciCaupolican Alvarado
Jul 17, 2020·Frontiers in Medicine·Giuseppe Stefano NettiMario Giordano
Apr 24, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Elisa YlinenHarri Saxén
Aug 12, 2021·European Journal of Pediatrics·Caoimhe CostiganKathleen M Gorman
Feb 14, 2021·Pediatrics·Clare C BrownParthak Prodhan

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