Neumann M, Urizar R
ANNA J. 1994 Apr;21(2):137-43; quiz 144-5.
The combination of microangiopathic hemolytic anemia, thrombocytopenia, and renal failure, referred to as hemolytic uremic syndrome (HUS), is one of the main causes of acute renal failure in children. In most patients, infection with verotoxin-producing E. coli (VTEC, serotype O157:H7) precedes the development of bloody diarrhea (D+) characteristic of enteropathic HUS cases. In a minority, however, neither the enteropathogenic bacteria nor bloody diarrhea (D-) are documented. Despite that the pathogenesis of the two varieties remains unclear, clinical differentiation between D+ and D- HUS is extremely important to the final outcome. A more severe course, which may result in end stage renal disease, is frequently observed in the D- group.
微血管病性溶血性贫血、血小板减少症和肾衰竭的组合，称为溶血尿毒综合征（HUS），是儿童急性肾衰竭的主要原因之一。在大多数患者中，产志贺毒素大肠杆菌（VTEC，血清型O157:H7）感染先于肠病性HUS病例特征性的血性腹泻（D+）出现。然而，少数患者既无肠道致病菌记录，也无血性腹泻（D-）记录。尽管这两种类型的发病机制尚不清楚，但D+和D- HUS的临床鉴别对最终结局极为重要。在D-组中经常观察到更严重的病程，这可能导致终末期肾病。
