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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
3
|
| pubmed:dateCreated |
1988-5-31
|
| pubmed:abstractText |
A case of hemolytic-uremic syndrome (HUS) associated with an infection by a verotoxin-producing Escherichia coli (VTEC), serotype 0111:NM, in a 22-year-old woman who had been on oral contraceptives is presented. VTEC-associated cases of HUS infected by E. coli 0111 have been reported before, but never in adults. The kinetics of the humoral immune response to verotoxin in the patient is observed over three months and described for the first time. The possible role of contraceptives that have been incriminated in the etiology of HUS before is discussed as well. Possible benefits of therapeutical interventions such as hemodialysis, therapeutic plasma exchange, converting enzyme inhibitors, or antibiotics still need clarification. However, it is strongly suggested to include tests for VTEC in the work-up of patients suffering from HUS.
|
| pubmed:keyword |
http://linkedlifedata.com/resource/pubmed/keyword/Biology,
http://linkedlifedata.com/resource/pubmed/keyword/Case Studies,
http://linkedlifedata.com/resource/pubmed/keyword/Contraception,
http://linkedlifedata.com/resource/pubmed/keyword/Contraceptive Methods--side effects,
http://linkedlifedata.com/resource/pubmed/keyword/Demographic Factors,
http://linkedlifedata.com/resource/pubmed/keyword/Developed Countries,
http://linkedlifedata.com/resource/pubmed/keyword/Diseases,
http://linkedlifedata.com/resource/pubmed/keyword/Europe,
http://linkedlifedata.com/resource/pubmed/keyword/Family Planning,
http://linkedlifedata.com/resource/pubmed/keyword/Germany, Federal Republic Of,
http://linkedlifedata.com/resource/pubmed/keyword/Hematological Effects,
http://linkedlifedata.com/resource/pubmed/keyword/Hemic System,
http://linkedlifedata.com/resource/pubmed/keyword/Hypertension,
http://linkedlifedata.com/resource/pubmed/keyword/Infections,
http://linkedlifedata.com/resource/pubmed/keyword/Longterm Effects,
http://linkedlifedata.com/resource/pubmed/keyword/Oral Contraceptives, Combined--side...,
http://linkedlifedata.com/resource/pubmed/keyword/Oral Contraceptives--side effects,
http://linkedlifedata.com/resource/pubmed/keyword/Physiology,
http://linkedlifedata.com/resource/pubmed/keyword/Population,
http://linkedlifedata.com/resource/pubmed/keyword/Population Dynamics,
http://linkedlifedata.com/resource/pubmed/keyword/Research Methodology,
http://linkedlifedata.com/resource/pubmed/keyword/Signs And Symptoms,
http://linkedlifedata.com/resource/pubmed/keyword/Studies,
http://linkedlifedata.com/resource/pubmed/keyword/Time Factors,
http://linkedlifedata.com/resource/pubmed/keyword/Vascular Diseases,
http://linkedlifedata.com/resource/pubmed/keyword/Western Europe
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical | |
| pubmed:status |
MEDLINE
|
| pubmed:month |
Mar
|
| pubmed:issn |
0301-0430
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
29
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
153-8
|
| pubmed:dateRevised |
2007-11-15
|
| pubmed:otherAbstract |
PIP: Confirmation of a causal relationship between hemolytic-uremic syndrome (HUS) and verotoxin-producing Escherichia coli (VTEC) infection is provided by the case of a 22-year-old West German woman. The patient presented with fatigue, nausea, and headache. Ultrasonography revealed enlarged kidneys, and laboratory investigations showed uremia, hemolytic anemia, lactate dehydrogenase, haptoglobin below the detection limit, and thrombocytopenia. She received hemodialysis and drug treatment (heparin, dopamine, and furosemide). To investigate the kinetics of the humoral response to verotoxin, the patient was followed for 3 months. Fecal specimens on day 23 yielded E coli serotype 0111:NM, and stool filtrates on days 16 and 23 showed highly cytotoxic activity for HeLa cells. While the patient's initial serum showed a high IgM immune response against purified Shiga toxin, there was a steady decline in IgM and steady increase in IgG antibodies over the ensuing 3 months. These findings are suggestive of a recent infection by a verotoxin-producing organism. This is the 1st reported case of VTEC-associated HUS with e coli 0111 infection in an adult, and the patient's 4-year history of oral contraceptives (OCs)--ethinyl estradiol and chlormadinoneacetate--is considered to be of etiologic significance. The diminished antibody coating of bacteria in the urinary tract of OC users may have facilitated invasion of verotoxin across the mucosal barrier in this patient. Severe hypertension has been reported previously in OC users with HUS. It is speculated that verotoxin may trigger HUS in longterm OC users, initiating vasoconstriction and microangiopathic hemolysis.
|
| pubmed:meshHeading |
pubmed-meshheading:3282732-Adult,
pubmed-meshheading:3282732-Bacterial Toxins,
pubmed-meshheading:3282732-Contraceptives, Oral, Synthetic,
pubmed-meshheading:3282732-Escherichia coli,
pubmed-meshheading:3282732-Escherichia coli Infections,
pubmed-meshheading:3282732-Female,
pubmed-meshheading:3282732-Hemolytic-Uremic Syndrome,
pubmed-meshheading:3282732-Humans,
pubmed-meshheading:3282732-Shiga Toxin 1
|
| pubmed:year |
1988
|
| pubmed:articleTitle |
Hemolytic-uremic syndrome associated with an infection by verotoxin producing Escherichia coli 0111 in a woman on oral contraceptives.
|
| pubmed:affiliation |
Department of Medicine, University Hospital Eppendorf, Hamburg, FRG.
|
| pubmed:publicationType |
Journal Article,
Case Reports
|