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• W2024552812 abstract "In May, 2011, an outbreak of enterohaemorrhagic Escherichia coli (EHEC) O104:H4 occurred in Germany. On July 27, the outbreak was over but had by then caused 3469 cases of EHEC infection and 852 cases of haemolytic uraemic syndrome. 50 patients died, including 18 patients with EHEC and 32 with haemolytic uraemic syndrome. 1 Robert Koch InstituteEHEC/HUS O104:H4—the outbreak is considered to be over. http://www.rki.de/cln_110/nn_217400/EN/Home/PM__EHEC.htmlDate: July 26, 2011 Google Scholar The strain of E coli was unusual in that it mainly affected adults (89% of patients, with a median age of 43 years) and women (68%). 25% of cases of EHEC progressed to haemolytic uraemic syndrome, which was much higher than the 6% reported through active surveillance of Shiga-toxin (Stx) producing EHEC O157 in the USA. 2 Frank C Werber D Cramer JP et al. for the HUS investigation teamEpidemic profile of Shiga-toxin-producing Escherichia coli O104:H4 outbreak in Germany—preliminary report. N Engl J Med. 2011; (published online June 22.)https://doi.org/10.1056/NEJMoa1106483 Crossref Scopus (872) Google Scholar Although haemolytic uraemic syndrome chiefly affects the renal system, neurological complications can occur and are associated with high mortality. 3 Nathanson S Kwon T Elmaleh M et al. Acute neurological involvement in diarrhea-associated hemolytic uremic syndrome. Clin J Am Soc Nephrol. 2010; 5: 1218-1228 Crossref PubMed Scopus (153) Google Scholar In The Lancet, Andreas Greinacher and colleagues 4 Greinacher A Friesecke S Abel P et al. Treatment of severe neurological deficits with IgG depletion through immunoadsorption in patients with Escherichia coli O104:H4-associated haemolytic uraemic syndrome: a prospective trial. Lancet. 2011; (published online Sept 5.)https://doi.org/10.1016/S0140-6736(11)61253-1 Summary Full Text Full Text PDF PubMed Scopus (116) Google Scholar present results from a trial in which they treated 12 patients with severe neurological complications from haemolytic uraemic syndrome with IgG immunoadsorption. The neurological sequelae were non-responsive to plasma exchange and eculizumab (a monoclonal antibody that blocks complement), and no von Willebrand factor deficiency or antibodies were detected. All patients survived and all but two had complete recovery of neurological and renal function. Treatment of severe neurological deficits with IgG depletion through immunoadsorption in patients with Escherichia coli O104:H4-associated haemolytic uraemic syndrome: a prospective trialAntibodies are probably involved in the pathogenesis of severe neurological symptoms in patients with E coli O104:H4-induced haemolytic uraemic syndrome. Immunoadsorption can safely be used to rapidly ameliorate these severe neurological complications. Full-Text PDF" @default.
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• W2024552812 date "2011-09-01" @default.
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• W2024552812 title "Immunoadsorption for haemolytic uraemic syndrome" @default.
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• W2024552812 doi "https://doi.org/10.1016/s0140-6736(11)61342-1" @default.
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