Shambhuprasad K Togarsimalemath1,2, Ali Si-Mohammed3, Mamta Puraswani4, Aarti Gupta4, Astrid Vabret5, Sandrine Liguori6, Patricia Mariani-Kurkdjian6, Arvind Bagga4, Marie-Agnes Dragon-Durey7,8,9. 1. INSERM UMRS 1138, team "Complement and disease", Cordeliers Research Center, Paris, France. 2. Paris Descartes University, Paris, France. 3. Laboratoire de Virologie, Centre National de Référence (CNR) des virus entériques, CHU de Dijon, Dijon, France. 4. Department of Pediatrics, Division of Nephrology, All India Institute of Medical Sciences, New Delhi, India. 5. Laboratoire de Virologie, CNR de la Rougeole et des Paramyxoviridae respiratoires humains, CHU de Caen, Caen, France. 6. Service de Microbiologie, CNR associé Escherichia coli, CHU Robert Debré, APHP, Paris, France. 7. INSERM UMRS 1138, team "Complement and disease", Cordeliers Research Center, Paris, France. marie-agnes.durey@aphp.fr. 8. Paris Descartes University, Paris, France. marie-agnes.durey@aphp.fr. 9. Laboratoire d'Immunologie, Hôpital Européen Georges Pompidou, APHP, Paris, France. marie-agnes.durey@aphp.fr.
Abstract
BACKGROUND: Prodromal symptoms are frequently reported in the atypical form of Hemolytic uremic syndrome (aHUS) suggesting implication of infectious triggers. Some pathogens may also play a role in the mechanisms of production of autoantibody directed against Factor H (FH), a complement regulator, leading to aHUS. METHODS: The presence of 15 gastrointestinal (GI) pathogens was investigated by using xTAG-based multiplex PCR techniques on stools collected at the acute phase in a cohort of Indian HUS children classified according to the presence or absence of anti-FH autoantibodies. RESULTS: Prevalence of pathogens in patients with anti-FH antibody (62.5%) was twice that in those without (31.5%). Different pathogens were detected, the most frequent being Clostridium difficile, Giardia intestinalis, Salmonella, Shigella, Rotavirus, Norovirus and Entamoeba histolytica. No stool was positive for Shigatoxin. CONCLUSION: This study reveals a higher prevalence of GI pathogens in anti-FH positive than in negative patients. No single pathogen was implicated exclusively in one form of HUS. These pathogens may play a role in the disease initiation by inducing complement activation or an autoimmune response.
BACKGROUND: Prodromal symptoms are frequently reported in the atypical form of Hemolytic uremic syndrome (aHUS) suggesting implication of infectious triggers. Some pathogens may also play a role in the mechanisms of production of autoantibody directed against Factor H (FH), a complement regulator, leading to aHUS. METHODS: The presence of 15 gastrointestinal (GI) pathogens was investigated by using xTAG-based multiplex PCR techniques on stools collected at the acute phase in a cohort of Indian HUS children classified according to the presence or absence of anti-FH autoantibodies. RESULTS: Prevalence of pathogens in patients with anti-FH antibody (62.5%) was twice that in those without (31.5%). Different pathogens were detected, the most frequent being Clostridium difficile, Giardia intestinalis, Salmonella, Shigella, Rotavirus, Norovirus and Entamoeba histolytica. No stool was positive for Shigatoxin. CONCLUSION: This study reveals a higher prevalence of GI pathogens in anti-FH positive than in negative patients. No single pathogen was implicated exclusively in one form of HUS. These pathogens may play a role in the disease initiation by inducing complement activation or an autoimmune response.
Authors: S Baid; M Pascual; W W Williams; N Tolkoff-Rubin; S M Johnson; B Collins; R T Chung; F L Delmonico; A B Cosimi; R B Colvin Journal: J Am Soc Nephrol Date: 1999-01 Impact factor: 10.121
Authors: Martin Tagle; Jose A Barriga; Sussy Gutierrez; Luis Manuel Valdez; James Castle; Antonio Antunez De Mayolo; Yolanda Scavino Levy; Raúl León Barúa; Carlos Mendoza; Lucy Cajas; Vilma Santibáñez Journal: Rev Gastroenterol Peru Date: 2004 Jan-Mar