Hemolytic-uremic syndrome associated with an infection by verotoxin producing Escherichia coli 0111 in a woman on oral contraceptives.

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.