Pneumococcal hemolytic uremic syndrome and steroid resistant nephrotic syndrome

Groves, Andrew; Reich, Patrick; Sigdel, Binayak; Davis, Thomas K.

doi:10.1093/ckj/sfw025

Cited by 14 publications

(21 citation statements)

References 29 publications

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“…Invasive pneumococcal disease is defined as severe pneumococcal disease causing meningitis, bacteremia, sepsis or thoracic empyema. Although pneumococcal disease is common in both children and adults, pTMA usually occurs in children [5,6]. There is a possibility that splenectomy and immunosuppression are associated with pTMA in adults [6].…”

Section: Discussionmentioning

confidence: 99%

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Streptococcus pneumoniae-associated thrombotic microangiopathy in an immunosuppressed adult

et al. 2020

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AbstractA 62-year-old male who was receiving prednisolone and methotrexate for scleroderma and rheumatoid arthritis complained of diarrhea and vomiting, and was transferred to our hospital for detailed examination and treatment of renal dysfunction and thrombocytopenia. Hemolytic anemia and crushed erythrocytes were found during the patient’s course; therefore, we suspected thrombotic microangiopathy (TMA). His ADAMTS13 activity was 60.3% and his ADAMTS13 inhibitor was under 0.5. In addition, his blood culture was positive for Streptococcus pneumoniae, and we finally diagnosed Streptococcus pneumoniae-associated TMA (pTMA). The patient was treated with antibiotics and hemodialysis. The patient recovered and was discharged on the 45th hospital day. Adult pTMA cases are remarkably rare. We herein report a successfully treated adult case of pTMA.

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Section: Discussionmentioning

confidence: 99%

“…Endothelial injury activates a microangiopathic cascade of thrombotic vascular injury and leads to TMA [5]. In pTMA, S. pneumoniae cleaves N-acetylneuraminic acid and exposes the Thomsen-Friedenreich antigen (T-antigen) on glomerular endothelial cell glycoproteins [8].…”

Section: Discussionmentioning

confidence: 99%

Streptococcus pneumoniae-associated thrombotic microangiopathy in an immunosuppressed adult

et al. 2020

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“…Hemolytic uremic syndrome (HUS) is characterized by the classic triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. 1 More than 90% of the cases occur after an infectious process caused by strains of Escherichia coli, which produce the Shiga-like toxin. 1 Streptococcus pneumoniae-associated hemolytic uremic syndrome (Sp-HUS) is an infrequent but severe complication of invasive pneumococcal infection, first described by Fischer et al in 1971.…”

Section: Introductionmentioning

confidence: 99%

“…1 More than 90% of the cases occur after an infectious process caused by strains of Escherichia coli, which produce the Shiga-like toxin. 1 Streptococcus pneumoniae-associated hemolytic uremic syndrome (Sp-HUS) is an infrequent but severe complication of invasive pneumococcal infection, first described by Fischer et al in 1971. 2 It is currently responsible for 5 to 15% of all HUS cases worldwide.…”

Section: Introductionmentioning

confidence: 99%

“…6,7 The clinical course is typically more severe and associated with increased mortality. 1,8 Sp-HUS treatment is primarily supportive through the early administration of antibiotics, blood transfusion, and renal replacement therapy as needed. 1,3,8 The purpose of this article is to describe a case series of four patients with HUS due to pneumococcus in a level four complexity institution in the city of Bogotá, D.C., Colombia.…”

Section: Introductionmentioning

confidence: 99%

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Hemolytic Uremic Syndrome Associated With Streptococcus Pneumoniae in Pediatrics: A Case Series

Guerra¹,

Rodríguez²,

Camacho

et al. 2020

Rev. paul. pediatr.

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Objective: To describe a case series of four (4) patients with hemolytic uremic syndrome due to Streptococcus pneumoniae in a level four complexity institution in the city of Bogotá, D.C., Colombia. Cases description: We describe cases of four patients who presented respiratory symptoms and fever. All four patients were in regular conditions on hospital admission, after which they required intensive care and ventilatory support. Upon admission, three cases showed evidence of pleuropulmonary complication. Penicillin-sensitive Streptococcus pneumoniae was isolated in all cases. All patients presented anemia, severe thrombocytopenia, schistocytes on peripheral blood smear, and hyperazotemia. They required blood transfusion and renal replacement therapy during their hospitalization. The patients were diagnosed with hemolytic uremic syndrome due to S. pneumoniae. Three of the four patients had a progressive recovery of the renal function and were discharged after an average of 36 days of hospital stay. The remaining patient had two amputations in the extremities due to thrombotic vascular complications and was discharged after 99 days of hospital stay, requiring hemodialysis every other day. Comments: Hemolytic uremic syndrome due to Streptococcus pneumoniae is a rare but severe complication of invasive pneumococcal disease. Complicated pneumonia is the main condition associated with this entity. It is noteworthy the short period in which these cases were presented, considering the low annual incidence of the disease.

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Current evolutions, applications, and challenges of phosphatidylethanol analysis for clinical and forensic purposes

Luginbühl¹,

Uytfanghe

Stöth

et al. 2022

WIREs Forensic Science

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Phosphatidylethanols (PEth) are a group of abnormal phospholipids which are formed within the human body in the presence of ethanol. As PEth accumulates in red blood cells, which prolongs its detectability, it became popular as a direct alcohol biomarker. When alcohol is consumed regularly, PEth concentrations in the human blood reach an equilibrium (plateau) between formation and degradation which is representative of drinking habits. A wide range of applications has been demonstrated for PEth, whereby in most studies it could provide advancements regarding accuracy and precision when compared to already established alcohol biomarkers (carbohydrate-deficient transferrin, gamma-glutamyltransferase, and ethyl glucuronide). Although PEth has been the focus of many research projects all around the world, the final breakthrough from the research laboratory into the clinical mass market is still ongoing. In this overview article, we discuss the evolution of PEth analysis, its applications, and the associated challenges. The main reasons that hinder the use of PEth in the mass market were identified as (a) the lack of implementing a uniform reference measurement system, which should ensure that every single PEth result is comparable and/or (b) ensuring good laboratory practice dedicated to PEth analysis, which should guarantee that every result obtained by an individual laboratory is correct. These challenges regarding PEth analytics must be carefully addressed in the near future before the implementation of common cut-off values and international guidelines can take place.

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Pneumococcal hemolytic uremic syndrome and steroid resistant nephrotic syndrome

Cited by 14 publications

References 29 publications

Streptococcus pneumoniae-associated thrombotic microangiopathy in an immunosuppressed adult

Streptococcus pneumoniae-associated thrombotic microangiopathy in an immunosuppressed adult

Hemolytic Uremic Syndrome Associated With Streptococcus Pneumoniae in Pediatrics: A Case Series

Current evolutions, applications, and challenges of phosphatidylethanol analysis for clinical and forensic purposes

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