López E L, Contrini M M, Devoto S, de Rosa M F, Graña M G, Aversa L, Gómez H F, Genero M H, Cleary T G
Department of Pediatric Infectious Diseases, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina.
J Pediatr. 1995 Sep;127(3):364-7. doi: 10.1016/s0022-3476(95)70064-1.
Argentina has an exceptionally high frequency of hemolytic-uremic syndrome (HUS). We sought to define prospectively the role of verocytotoxins (Shiga-like toxins [SLTs]) in 254 Argentinean children with grossly bloody diarrhea during spring and summer. Free fecal SLTs (I/II) and/or DNA probe-positive isolates were found in 99 (39%) of the children. During the follow-up period, HUS developed in 6 patients (4 with evidence of recent SLT infection based on stool studies); another 14 patients had some, but not all, of the abnormalities seen in typical HUS. The development of HUS or incomplete HUS in these children was significantly associated with recent SLT-Escherichia coli infection (p = 0.024). The high incidence of SLT-associated bloody diarrhea in Argentina explains, at least partially, the unusually high frequency of HUS. Our data indicate that incomplete forms of HUS may be common in patients with SLT-associated bloody diarrhea.
阿根廷溶血尿毒综合征（HUS）的发病率异常高。我们试图前瞻性地确定志贺毒素（类志贺毒素[SLTs]）在254名春夏季出现严重血性腹泻的阿根廷儿童中的作用。在99名（39%）儿童中发现了游离粪便SLTs（I/II）和/或DNA探针阳性分离株。在随访期间，6名患者发生了HUS（4名根据粪便研究有近期SLT感染证据）；另外14名患者有一些但并非典型HUS所见的所有异常。这些儿童中HUS或不完全HUS的发生与近期SLT-大肠杆菌感染显著相关（p = 0.024）。阿根廷SLT相关血性腹泻的高发病率至少部分解释了HUS异常高的发病率。我们的数据表明，不完全形式的HUS在SLT相关血性腹泻患者中可能很常见。
