Clostridium difficile Colitis Associated With Hemolytic-Uremic Syndrome

Mbonu, Charles Chisom; Davison, Danielle; El-Jazzar, Khaled M.; Simon, Gary L.

doi:10.1016/s0272-6386(03)00210-5

Cited by 16 publications

(8 citation statements)

References 27 publications

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“…It has been speculated that C. difficile cytotoxins A and B bind to specific receptors on colonic cell membranes and induce apoptosis leading to mucosal breach, access of cytotoxins to circulation, microvascular damage, and release of proinflammatory cytokines (7). The role of C. difficile cytotoxin on renal vasculature and HUS presentation needs further study (7). …”

Section: Discussionmentioning

confidence: 99%

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Hemolytic uremic syndrome andClostridium difficilecolitis

Keshtkar-Jahromi

Mohebtash

2012

Journal of Community Hospital Internal Medicine Perspectives

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Section: Discussionmentioning

confidence: 99%

“…After C. difficile was determined to be the causative agent for PMC, some cases of HUS related to PMC in children were reported (5, 6). Only two cases of C. difficile -related HUS in adults have been reported (1, 7). We report a case of C. difficile -related HUS in an adult patient and provide a review of the literature.…”

mentioning

confidence: 99%

Hemolytic uremic syndrome andClostridium difficilecolitis

Keshtkar-Jahromi

Mohebtash

2012

Journal of Community Hospital Internal Medicine Perspectives

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“…Pseudomembraneous colitis may be associated with RBC fragmentation and the hemolytic uremic syndrome in patients with C. difficile colitis has been described. 40 Similarly with central venous line infection it is probably septicemia associated with schistocytes that qualifies patients for the diagnosis of TAM given the definition used. Alternatively, TAM may be precipitated by infectious complications similar to GvHD.…”

Section: Discussionmentioning

confidence: 99%

Transplant-associated microangiopathy (TAM) in recipients of allogeneic hematopoietic stem cell transplants

Martínez

Bucher

Stüssi

et al. 2005

Bone Marrow Transplant

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Summary:We studied occurrence, risk factors and outcome of patients with transplant-associated microangiopathy (TAM) after allogeneic stem cell transplantation (HSCT). A total of 221 consecutive patients were transplanted between 1995 and 2002. TAM is defined as evidence of hemolysis and schistocytes in the first 100 days. Outcomes analyzed included TAM and overall survival. Of 221 patients, 68 had TAM. The cumulative incidence was 31 (25-38)% at 100 days. Patients with TAM had higher LDH, higher bilirubin, higher creatinine and more often neurologic symptoms. TAM was not associated with stem cell source, cyclosporine levels and was not more frequent in recent years. In multivariate analysis, risk factors for TAM included donor type, age, gender, ABO-incompatibility and acute graft-versus-host disease (aGvHD). In patients with TAM, 1-year survival was lower than in patients without TAM (27718% for TAM with high schistocyte counts; 53715% for TAM with low schistocyte counts; vs 7877% in patients without TAM; Po0.0001). TAM was independently associated with mortality adjusting for donor type, age and aGvHD occurrence and severity. TAM is frequent after HSCT and is associated with mortality even after adjustment for aGvHD grade. Risk factors of TAM are similar to aGvHD. TAM may represent endothelial damage driven by donor-host interactions.

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“…The association between 658240462 Clostridium difficile and HUS is not as obvious. There are a few cases reported from 1977 which indicate that HUS is a possible, but very rare, complication of CDI (TOCHEN & CAMPBELL 1977;MBONU et al 2003;KESHTKAR-JAHROMI & MOHEBTASH 2012;ALVARADO et al 2014). The mechanism of this process is not understood but it is known that C. diff.…”

Section: Fatty Acidsmentioning

confidence: 99%

n-3 and n-6 Fatty Acid Changes in the Erythrocyte Membranes of Patients with <I>Clostridium difficile</I> Infection

Czepiel¹,

Gdula‐Argasińska²,

Garlicki³

2016

folia biol (krakow)

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and n-6 fatty acid changes in the erythrocyte membranes of patients with Clostridium difficile infection. Folia Biologica (Kraków) 64: 3-10. The implications of circulating essential fatty acids (FA) on the inflammatory risk profile and clinical outcome are still unclear. In order to gain a deeper understanding of the role of polyunsaturated fatty acids (PUFA) in the pathogenesis of acute infection, we analyzed the FA content in red blood cell (RBC) membranes of patients with Clostridium difficile infection (CDI) and controls. We prospectively studied 60 patients including 30 patients with CDI and 30 controls to assess lipid concentrations in erythrocyte membranes using gas chromatography. We observed a higher level of saturated fatty acids (SFA) in RBC membranes from patients with CDI. In patients with CDI, we also noticed a higher level of 20:4 n-6 FA and only a small amounts of C20:2n-6, C20:3n-6 FAs, arachidonic acid (AA) precursors, which suggest an intense inflammatory reaction in the organism during infection. We also noticed low levels of n-3 FA in the RBC membranes of patients infected with CDI. There is a deficit of n-3 FA in patients with CDI. n-3 FA are probably used during CDI as precursors of pro-resolving mediators that may indicate a therapeutic role of n-3 PUFAs in CDI. The changes in fatty acids in erythrocyte membranes during CDI alter their functions which may have an impact on the clinical outcome.

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Clostridium difficile Colitis Associated With Hemolytic-Uremic Syndrome

Cited by 16 publications

References 27 publications

Hemolytic uremic syndrome andClostridium difficilecolitis

Hemolytic uremic syndrome andClostridium difficilecolitis

Transplant-associated microangiopathy (TAM) in recipients of allogeneic hematopoietic stem cell transplants

n-3 and n-6 Fatty Acid Changes in the Erythrocyte Membranes of Patients with <I>Clostridium difficile</I> Infection

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