Gastrointestinal pathogens in anti-FH antibody positive and negative Hemolytic Uremic Syndrome.

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.

journal_name

Pediatr Res

journal_title

Pediatric research

authors

Togarsimalemath SK,Si-Mohammed A,Puraswani M,Gupta A,Vabret A,Liguori S,Mariani-Kurkdjian P,Bagga A,Dragon-Durey MA

doi

10.1038/s41390-018-0009-9

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

118-124

issue

1

eissn

0031-3998

issn

1530-0447

pii

10.1038/s41390-018-0009-9

journal_volume

84

pub_type

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